TABLE 2.
Ranked Scores for Measure of Moral Distress for Healthcare Professionals Items
| Measure of Moral Distress—Healthcare Professionals Item | Mean | sd | Rank |
|---|---|---|---|
| Follow the family insistence to continue aggressive treatment even though it is not in the best interest of the patient. | 8.15 | 4.8 | 1 |
| Continue to provide aggressive treatment for a person who is most likely to die regardless of this treatment when no one will make a decision to withdraw it. | 7.04 | 4.9 | 2 |
| Experience lack of administrative action or support for a problem that is compromising patient care. | 5.11 | 5.1 | 3 |
| Experience compromised patient care due to lack of resources/equipment/bed capacity. | 4.92 | 5.0 | 4 |
| Be required to care for patients who have unclear or inconsistent treatment plans or who lack goals of care. | 4.81 | 4.3 | 5 |
| Have excessive documentation requirements that compromise patient care. | 4.64 | 5.0 | 6 |
| Participate in care that causes unnecessary suffering or does not adequately relieve pain or symptoms. | 4.59 | 4.3 | 7 |
| Feel pressured to order or carry out orders for that I consider to be unnecessary or inappropriate treatments. | 4.42 | 4.2 | 8 |
| Be required to care for more patient than I can safely care for. | 4.20 | 4.7 | 9 |
| Witness healthcare providers giving “false hope” to a patient or family. | 4.14 | 4.0 | 10 |
| Watch patient care suffer because of a lack of provider continuity. | 4.03 | 4.1 | 11 |
| Witness low quality of patient care due to poor team communication. | 3.81 | 4.0 | 12 |
| Be required to work with abusive patients/family members who are compromising quality of care. | 3.64 | 3.9 | 13 |
| Participate on a team that gives inconsistent messages to a patient/family. | 3.38 | 3.9 | 14 |
| Be required to work with other healthcare team members who are not as competent as patient care requires. | 3.32 | 4.1 | 15 |
| Be unable to provide optimal care due to pressures from administration or insurers to reduce cost. | 2.89 | 4.5 | 16 |
| Participate in care that I do not agree with but do so because fears of litigation. | 2.81 | 3.7 | 17 |
| Feel required to overemphasize tasks and productivity or quality measures at the expense of patient care. | 2.70 | 4.1 | 18 |
| Fear retribution if I speak up. | 2.63 | 4.5 | 19 |
| Work within power hierarchies in teams, units, and my institution that compromises patient care. | 2.49 | 4.2 | 20 |
| Work with team members who do not treat vulnerable or stigmatized patients with dignity and respect. | 1.90 | 3.2 | 21 |
| Follow a physician’s or family member’s requests not to discuss the patient’s prognosis with the patient/family. | 1.87 | 2.6 | 22 |
| Feel pressured to ignore situations in which patients have not been given adequate information to ensure informed consent. | 1.61 | 3.0 | 23 |
| Feel unsafe/bullied amongst my own colleagues. | 1.59 | 3.6 | 24 |
| Witness a violation of a standard of practice or a code of ethics and not feel sufficiently supported to report the violation. | 1.46 | 3.3 | 25 |
| Be pressured to avoid taking action when I learn that a physician, nurse, or other team colleague has made a medical error and does not report it. | 1.20 | 2.7 | 26 |
| Be required to care for patients whom I do not feel qualified to care for. | 1.05 | 2.1 | 27 |