Gendered and racial experiences of moral distress: A scoping review

Author:

Mũrage Alice12ORCID,Morgan Rosemary3,Samji Hasina1,Smith Julia12

Affiliation:

1. Faculty of Health Sciences Simon Fraser University Burnaby British Columbia Canada

2. Pacific Institute on Pathogens, Pandemics, and Society Burnaby British Columbia Canada

3. Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA

Abstract

AbstractAimTo inform efforts to integrate gender and race into moral distress research, the review investigates if and how gender and racial analyses have been incorporated in such research.DesignScoping review.MethodsThe PRISMA (Preferred Reporting Items for Systematic and Meta‐Analysis) Extension for Scoping Reviews was adopted.Data SourcesSystematic literature search was conducted through PubMed, CINAHL and Web of Science databases. Boolean operators were used to identify moral distress literature which included gender and/or race data and published between 2012 and 2022.ResultsAfter screening and full‐text review, 73 articles reporting on original moral distress research were included. Analysis was conducted on how gender and race were incorporated in research and interpretation of moral distress experiences among healthcare professionals.ImpactThis study found that while there is an upward trend in including gender and race‐disaggregated data in moral distress research, over half of such research did not conduct in‐depth analysis of such data. Others only highlighted differential experiences such as moral distress levels of women vis‐à‐vis men. Only about 20% of publications interrogated how experiences of moral distress differed and/or explored factors behind their findings.ConclusionThere is a need to not only collect disaggregated data in moral distress research but also engage this data through gender and race‐based analysis. Particularly, we highlight the need for intersectional analysis, which can elucidate how social identities and categories (such as gender and race) and structural inequalities (such as those sustained by sexism and racism) interact to influence moral experiences.Implications for the Profession and/or Patient CareMoral distress as experienced by healthcare professionals is increasingly recognized as an important area of research with significant policy implications in the healthcare sector. This study offers insights for nuanced and targeted policy approaches.Patient or Public ContributionNo patient or public contribution.

Funder

Canadian Institutes of Health Research

Michael Smith Health Research BC

Publisher

Wiley

Subject

General Nursing

Reference79 articles.

1. Moral distress among midwives working in the labour ward of a hospital in Ghana

2.

Prevalence of severe moral distress among healthcare providers in Saudi Arabia

3. Relationships among palliative care, ethnical climate, empowerment, and moral distress in intensive care unit nurses;Altaker K. W.;Healthy Work Environments,2018

4. Burnout and moral resilience in interdisciplinary healthcare professionals

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