Systematic scoping review on moral distress among physicians Article Swipe
YOU?
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· 2022
· Open Access
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· DOI: https://doi.org/10.1136/bmjopen-2022-064029
Background Concepts of moral distress (MD) among physicians have evolved and extend beyond the notion of psychological distress caused by being in a situation in which one is constrained from acting on what one knows to be right. With many accounts involving complex personal, professional, legal, ethical and moral issues, we propose a review of current understanding of MD among physicians. Methods A systematic evidence-based approach guided systematic scoping review is proposed to map the current concepts of MD among physicians published in PubMed, Embase, PsycINFO, Web of Science, SCOPUS, ERIC and Google Scholar databases. Concurrent and independent thematic and direct content analysis (split approach) was conducted on included articles to enhance the reliability and transparency of the process. The themes and categories identified were combined using the jigsaw perspective to create domains that form the framework of the discussion that follows. Results A total of 30 156 abstracts were identified, 2473 full-text articles were reviewed and 128 articles were included. The five domains identified were as follows: (1) current concepts, (2) risk factors, (3) impact, (4) tools and (5) interventions. Conclusions Initial reviews suggest that MD involves conflicts within a physician’s personal beliefs, values and principles (personal constructs) caused by personal, ethical, moral, contextual, professional and sociocultural factors. How these experiences are processed and reflected on and then integrated into the physician’s personal constructs impacts their self-concepts of personhood and identity and can result in MD. The ring theory of personhood facilitates an appreciation of how new experiences create dissonance and resonance within personal constructs. These insights allow the forwarding of a new broader concept of MD and a personalised approach to assessing and treating MD. While further studies are required to test these findings, they offer a personalised means of supporting a physician’s MD and preventing burn-out.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjopen-2022-064029
- https://bmjopen.bmj.com/content/bmjopen/12/9/e064029.full.pdf
- OA Status
- gold
- Cited By
- 55
- References
- 195
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4294266713
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4294266713Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/bmjopen-2022-064029Digital Object Identifier
- Title
-
Systematic scoping review on moral distress among physiciansWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-09-01Full publication date if available
- Authors
-
Chrystie Wan Ning Quek, Ryan Rui Song Ong, Ruth Wong, Sarah Wye Kit Chan, Amanda Kay-Lyn Chok, Grace Shen Shen, Andrea York Tiang Teo, Aiswarya Panda, Neha Burla, Yu An Wong, Ryan Choon Hoe Chee, Caitlin Yuen Ling Loh, Kun Woo Lee, Gabrielle Hui Ning Tan, Ryan Emmanuel Jian Leong, Natalie Song Yi Koh, Yun Ting Ong, Annelissa Chin, Min Chiam, Crystal Lim, Xuelian Zhou, Simon Yew Kuang Ong, Eng Koon Ong, Lalit Kumar Radha KrishnaList of authors in order
- Landing page
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https://doi.org/10.1136/bmjopen-2022-064029Publisher landing page
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https://bmjopen.bmj.com/content/bmjopen/12/9/e064029.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://bmjopen.bmj.com/content/bmjopen/12/9/e064029.full.pdfDirect OA link when available
- Concepts
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PsycINFO, Medicine, Personhood, Psychological intervention, CINAHL, Thematic analysis, Personal identity, MEDLINE, Psychology, Social psychology, Qualitative research, Nursing, Epistemology, Self-concept, Sociology, Philosophy, Law, Political science, Social scienceTop concepts (fields/topics) attached by OpenAlex
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55Total citation count in OpenAlex
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2025: 14, 2024: 28, 2023: 12, 2022: 1Per-year citation counts (last 5 years)
- References (count)
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195Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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