Table 2.
Answersa to questionnaire (all respondents)
| Questions |
Total (n) % |
Agreeb (n) % |
Disagreec (n) % |
||
|---|---|---|---|---|---|
| Moral distress - Quality of care | |||||
| 1. I felt I delivered the same quality of care compared to before. | (178) 100 | (46) 26 | (100) 56 | ||
| 2. It touched me to see when a patient was not receiving good care. | (178) 100 | (112) 63 | (20) 11 | ||
| 3. In most situations I had a strong sense of what did not constitute good care. | (178) 100 | (116) 65 | (13) 7 | ||
| 4. I had strong beliefs about ‘good’ and ‘bad’ patient care. | (178) 100 | (123) 69 | (12) 7 | ||
| 5. I feel my colleagues provided good care. | (178) 100 | (126) 71 | (11) 6 | ||
| 6. I felt I carried out medical tests and treatments which I myself found unnecessary. | (178) 100 | (23) 13 | (126) 71 | ||
| 7. I witnessed a patient suffering as a result of a lack of continuity of caregivers. | (178) 100 | (38) 21 | (108) 61 | ||
| 8. I felt had to choose between good care and something else I find important. | (178) 100 | (52) 29 | (86) 48 | ||
| 9. I felt we provided suboptimal care because there was not enough personal protective equipment, time or manpower available. | (178) 100 | (76) 43 | (82) 46 | ||
| 10. I felt I could do less for the patients than I used to. | (178) 100 | (100) 56 | (58) 33 | ||
| Moral distress – Emotional stress | |||||
| 11. Strong feelings arose when I saw a patient suffering. | (178) 100 | (87) 49 | (40) 22 | ||
| 12. I felt strongly about the well-being of the patients. | (178) 100 | (143) 80 | (4) 2 | ||
| 13. I felt that, in order to be able to finish my tasks, I had to put my values and views regarding good care aside. | (178) 100 | (63) 35 | (88) 49 | ||
| 14. I was worried my work was emotionally numbing me. | (178) 100 | (65) 37 | (82) 46 | ||
| 15. I frequently thought to myself: what am I actually doing here? | (178) 100 | (73) 41 | (73) 41 | ||
| 16. Compared to before, I enjoyed my work less. | (178) 100 | (77) 43 | (70) 39 | ||
| 17. I worried about my work. | (178) 100 | (87) 49 | (57) 32 | ||
| Team cooperation | |||||
| 1. At the ICU, there was regular reflection on the quality of care we provided from the different perspectives of the employees. | (170) 95.6 | (53) 31 | (73) 43 | ||
| 2. At the ICU there was an open and constructive culture in which criticism could easily be expressed. | (170) 95.6 | (63) 37 | (48) 28 | ||
| 3. At the ICU there was regular structural discussion between the various disciplines within the team about patient care. | (170) 95.6 | (69) 41 | (46) 27 | ||
| 4. At the ICU there were regular opportunities for open and informal discussions between care providers. | (170) 95.6 | (99) 58 | (32) 19 | ||
| 5. At the ICU, I had confidence in the professional competencies of my team members. | (178) 100 | (132) 74 | (16) 9 | ||
| Ethical climate | |||||
| 1. At the ICU I was always considered and addressed as a full member of the team by everyone in the team. | (178) 100 | (109) 61 | (49) 28 | ||
| 2. At the ICU, team members from another discipline respected my work. | (178) 100 | (126) 71 | (26) 15 | ||
| 3. I considered being vulnerable as a sign of weakness. | (170) 95.6 | (27) 16 | (122) 72 | ||
| Ways of dealing with challenges around end of life decisions | |||||
| 1. At the ICU there was a structured formal debrief after a difficult situation in patient care. | (174) 97.8 | (56) 32 | (58) 33 | ||
| 2. At the ICU, moral and ethical problems were discussed. | (176) 98.9 | (84) 48 | (40) 23 | ||
| 3. At the ICU, nurses were involved in end-of-life decisions. | (174) 97.8 | (57) 33 | (33) 19 | ||
| 4. At the ICU, there was good cooperation between nurses and physicians regarding end-of-life care. | (174) 97.8 | (84) 48 | (19) 11 | ||
| 5. Different opinions and values regarding end-of-life care were tolerated at the ICU. | (177) 99.4 | (104) 59 | (10) 6 | ||
| 6. My colleagues understood my ideas/feelings regarding difficult end-of-life decisions. | (177) 99.4 | (86) 49 | (5) 3 | ||
| 7. Providing care to patients who I thought shouldn’t receive care. | (178) 100 | (20) 11 | (128) 72 | ||
| 8. At the ICU, death was considered therapeutic failure, so decisions to scale back or not start therapy were rarely made. | (173) 97.2 | (17) 10 | (88) 51 | ||
| 9. Starting life-saving actions that I thought only delayed death. | (178) 100 | (79) 44 | (50) 28 | ||
| 10. At the ICU, end-of-life decisions were often postponed. | (172) 96.7 | (56) 33 | (49) 28 | ||
| 11. At the ICU, patients with a small chance of recovery regularly occupied an ICU bed from which other patients could benefit more. | (172) 96.7 | (52) 30 | (37) 22 | ||
Questions in cursive: question positively/neutrally formulated
Questions in non-cursive: question reversibly formulated
aExcluding ‘neutral’ answer
bCombined answers of ‘agree’ and ‘totally agree’
cCombined answers of ‘disagree’ and ‘totally disagree’