Moral distress among disaster responders: what is it, and can we do anything about it? A scoping review
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Series/Report no.:PREA Conference. Ethics and Humanitarian Research: Generating Evidence Ethically. The Fawcett Event Center, The Ohio State University, Columbus, Ohio, March 25-26, 2019. Presentation. Session 14. Oral Presentations 5. Paper B.
Moral challenges are frequently encountered by healthcare personnel involved in disaster response. Elevated needs and lack of time and resources, demands taking difficult decisions and priorities. Such challenging situations might lead to consequences such as moral distress and affected wellbeing, if the responder is left without support or not being able to find morally acceptable solutions in the situation. Therefore, disaster responders must be well trained and mentally prepared to manage morally challenging situations. To do so, more systematic knowledge is needed about the type and extent of moral challenges that responders face and how they deal with them. Research on moral distress is derived from non-disaster challenges in high resource settings and there is unclarity regarding different definitions and concepts of moral distress. This study elucidated how the concept of moral distress among disaster responders is defined and explained in the literature. A scoping review was used to systematically map the literature where 16 documents using the phrasing: moral stress, moral distress, ethical stress and ethical distress concerning disaster responders or humanitarian workers were included. The study found that different concepts describe the same phenomena where moral distress can be summarized as: a stressful reaction developed when a responder cannot follow inner moral values in various situations in disaster response. Three different types of definitions of moral distress were distinguished as referred to in the documents. Furthermore, risk- and protective factors for the development of moral distress and its potential consequences was summarized and illustrated in a conceptual model.
AUTHOR AFFILIATION: Martina Gustavsson, Karolinska Institutet, the Center for Research on Healthcare in Disasters, Sweden, firstname.lastname@example.org
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