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Coping with moral distress in oncology practice: nurse and physician strategies

An Lievrouw UGent, Stijn Vanheule UGent, Myriam Deveugele UGent, Martine De Vos UGent, Piet Pattyn UGent, Simon Van Belle UGent and Dominique Benoit UGent (2016) ONCOLOGY NURSING FORUM. 43(4). p.505-512
abstract
Purpose/Objectives: To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting. Research Approach: Qualitative interview study. Setting: Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium. Participants: 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. Methodologic Approach: Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis. Findings: Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes: a tendency to internalize or externalize moral distress, and a tendency to focus on rational or experiential elements. Each of the ways of coping had strengths and weaknesses. Doctors reported a mainly rational coping style, whereas nurses tended to focus on feelings and experiences. However, people appeared to change their ways of handling moral distress depending on personal or work-related experiences and perceived team culture. Prejudices were expressed about other professions. Conclusions: Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding. Interpretation: Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
UNITS, DETERMINANTS, CRITICAL-CARE, coping, oncology, cancer, caregiver, moral distress, CONFLICTS, EXPERIENCE
journal title
ONCOLOGY NURSING FORUM
Oncol. Nurs. Forum
volume
43
issue
4
pages
505 - 512
Web of Science type
Article
Web of Science id
000378087400016
JCR category
NURSING
JCR impact factor
1.763 (2016)
JCR rank
20/114 (2016)
JCR quartile
1 (2016)
ISSN
0190-535X
DOI
10.1188/16.ONF.505-512
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
7275562
handle
http://hdl.handle.net/1854/LU-7275562
date created
2016-06-21 09:15:35
date last changed
2017-06-21 06:59:26
@article{7275562,
  abstract     = {Purpose/Objectives: To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting. 
Research Approach: Qualitative interview study. 
Setting: Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium. 
Participants: 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. 
Methodologic Approach: Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis. 
Findings: Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes: a tendency to internalize or externalize moral distress, and a tendency to focus on rational or experiential elements. Each of the ways of coping had strengths and weaknesses. Doctors reported a mainly rational coping style, whereas nurses tended to focus on feelings and experiences. However, people appeared to change their ways of handling moral distress depending on personal or work-related experiences and perceived team culture. Prejudices were expressed about other professions. 
Conclusions: Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding. 
Interpretation: Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress.},
  author       = {Lievrouw, An and Vanheule, Stijn and Deveugele, Myriam and De Vos, Martine and Pattyn, Piet and Van Belle, Simon and Benoit, Dominique},
  issn         = {0190-535X},
  journal      = {ONCOLOGY NURSING FORUM},
  keyword      = {UNITS,DETERMINANTS,CRITICAL-CARE,coping,oncology,cancer,caregiver,moral distress,CONFLICTS,EXPERIENCE},
  language     = {eng},
  number       = {4},
  pages        = {505--512},
  title        = {Coping with moral distress in oncology practice: nurse and physician strategies},
  url          = {http://dx.doi.org/10.1188/16.ONF.505-512},
  volume       = {43},
  year         = {2016},
}

Chicago
Lievrouw, An, Stijn Vanheule, Myriam Deveugele, Martine De Vos, Piet Pattyn, Simon Van Belle, and Dominique Benoit. 2016. “Coping with Moral Distress in Oncology Practice: Nurse and Physician Strategies.” Oncology Nursing Forum 43 (4): 505–512.
APA
Lievrouw, A., Vanheule, S., Deveugele, M., De Vos, M., Pattyn, P., Van Belle, S., & Benoit, D. (2016). Coping with moral distress in oncology practice: nurse and physician strategies. ONCOLOGY NURSING FORUM, 43(4), 505–512.
Vancouver
1.
Lievrouw A, Vanheule S, Deveugele M, De Vos M, Pattyn P, Van Belle S, et al. Coping with moral distress in oncology practice: nurse and physician strategies. ONCOLOGY NURSING FORUM. 2016;43(4):505–12.
MLA
Lievrouw, An, Stijn Vanheule, Myriam Deveugele, et al. “Coping with Moral Distress in Oncology Practice: Nurse and Physician Strategies.” ONCOLOGY NURSING FORUM 43.4 (2016): 505–512. Print.