Moral Distress in Pediatric Residents and Pediatric Hospitalists: Sources and Association With Burnout
| Autor: | Kimberly O'Hara, Carla Falco, Jimmy Beck, Cameron L. Randall, Erin Sullivan, Douglas J. Opel, Hannah K. Bassett |
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| Rok vydání: | 2020 |
| Předmět: |
Response rate (survey)
medicine.medical_specialty Composite score business.industry Burnout Morals Confidence interval Hospital medicine 03 medical and health sciences Distress 0302 clinical medicine Cross-Sectional Studies Hospitalists 030225 pediatrics Family medicine Pediatrics Perinatology and Child Health Moral distress medicine Humans 030212 general & internal medicine Pediatricians business Association (psychology) Child Burnout Professional |
| Zdroj: | Academic pediatrics. 20(8) |
| ISSN: | 1876-2867 |
| Popis: | Objective Moral distress is increasingly identified as a major problem affecting healthcare professionals, but it is poorly characterized among pediatricians. Our objective was to assess the sources of moral distress in residents and pediatric hospitalist attendings and to examine the association of moral distress with reported burnout. Methods Cross-sectional survey from January through March 2019 of pediatric residents and hospital medicine attending physicians affiliated with 4 free-standing children's hospitals. Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals (MMD-HP). Burnout was measured using 2 items adapted from the Maslach Burnout Inventory. Results Respondents included 288 of 541 eligible pediatric residents (response rate: 53%) and 118 of 168 pediatric hospitalists (response rate: 70%; total response rate: 57%). The mean MMD-HP composite score was 93.4 (SD = 42.5). Residents reported significantly higher frequency scores (residents: M = 38.5 vs. hospitalists: M = 33.3; difference: 5.2, 95% confidence interval [CI], 2.9–7.5) and composite scores (residents: M = 97.6 vs hospitalists: M = 83.0; difference:14.6, 95% CI, 5.7–23.5) than hospitalists. The most frequent source of moral distress was “having excessive documentation requirements that compromise patient care,” and the most intense source of moral distress was “be[ing] required to work with abusive patients/family members who are compromising quality of care.” Significantly higher mean MMD-HP composite scores were observed among participants reporting that they felt burned out at least once per week (M= 114.6 vs M= 82.3; difference: 32.3, 95% CI, 23.5–41.2). Conclusions Pediatric residents and hospitalists report experiencing moral distress from a variety of patient-, team-, and system-level sources, and this distress is associated with burnout. |
| Databáze: | OpenAIRE |
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