“It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions

Objective:. We aimed to characterize sources of moral distress among providers in the context of surgery. Background:. Moral distress is defined as psychological unease generated when professionals identify an ethically correct action to take but are constrained in their ability to take that action....

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Main Authors: Adela Wu, MD, Sarah E. Bradley, PhD, MPH, CPH, C. Ann Vitous, MA, MPH, M. Andrew Millis, MD, MPH, Pasithorn A. Suwanabol, MD, MS
Format: Article
Language:English
Published: Wolters Kluwer Health 2024-12-01
Series:Annals of Surgery Open
Online Access:http://journals.lww.com/10.1097/AS9.0000000000000518
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author Adela Wu, MD
Sarah E. Bradley, PhD, MPH, CPH
C. Ann Vitous, MA, MPH
M. Andrew Millis, MD, MPH
Pasithorn A. Suwanabol, MD, MS
author_facet Adela Wu, MD
Sarah E. Bradley, PhD, MPH, CPH
C. Ann Vitous, MA, MPH
M. Andrew Millis, MD, MPH
Pasithorn A. Suwanabol, MD, MS
author_sort Adela Wu, MD
collection DOAJ
description Objective:. We aimed to characterize sources of moral distress among providers in the context of surgery. Background:. Moral distress is defined as psychological unease generated when professionals identify an ethically correct action to take but are constrained in their ability to take that action. While moral distress has been reported among healthcare providers, the perspectives of providers working in surgery specifically are not often explored and reported. Our study was developed from an overarching effort to investigate end-of-life care for seriously ill patients with surgical conditions. Methods:. Using convenience sampling, we conducted 48 semistructured interviews with providers who provide high-intensity care (eg, surgeons, anesthesiologists, intensivists, and midlevel providers) for seriously ill patients with surgical conditions across 14 Veterans Affairs hospitals. Interviews were analyzed iteratively using thematic content analysis. Results:. Providers described clinical encounters that generated moral distress while caring for seriously ill patients with surgical conditions: (1) difficulties in conflict resolution with and among patients and families; (2) specific types of patients or situations; (3) systemic factors hindering appropriate end-of-life care; (4) surgical culture and expectations of the surgeon’s role. Conclusions:. Providers caring for seriously ill patients with surgical conditions report emotions and reactions consistent with moral distress. Our study highlights important triggers for providers and hospital systems to identify and address throughout a surgical provider’s training and career.
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spelling doaj-art-dd63c680719f44be999fdbd8922750292025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e51810.1097/AS9.0000000000000518202412000-00024“It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical ConditionsAdela Wu, MD0Sarah E. Bradley, PhD, MPH, CPH1C. Ann Vitous, MA, MPH2M. Andrew Millis, MD, MPH3Pasithorn A. Suwanabol, MD, MS4From the * Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA† Department of Surgery, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI† Department of Surgery, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI‡ Department of Surgery, University of Michigan, Ann Arbor, MI.† Department of Surgery, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIObjective:. We aimed to characterize sources of moral distress among providers in the context of surgery. Background:. Moral distress is defined as psychological unease generated when professionals identify an ethically correct action to take but are constrained in their ability to take that action. While moral distress has been reported among healthcare providers, the perspectives of providers working in surgery specifically are not often explored and reported. Our study was developed from an overarching effort to investigate end-of-life care for seriously ill patients with surgical conditions. Methods:. Using convenience sampling, we conducted 48 semistructured interviews with providers who provide high-intensity care (eg, surgeons, anesthesiologists, intensivists, and midlevel providers) for seriously ill patients with surgical conditions across 14 Veterans Affairs hospitals. Interviews were analyzed iteratively using thematic content analysis. Results:. Providers described clinical encounters that generated moral distress while caring for seriously ill patients with surgical conditions: (1) difficulties in conflict resolution with and among patients and families; (2) specific types of patients or situations; (3) systemic factors hindering appropriate end-of-life care; (4) surgical culture and expectations of the surgeon’s role. Conclusions:. Providers caring for seriously ill patients with surgical conditions report emotions and reactions consistent with moral distress. Our study highlights important triggers for providers and hospital systems to identify and address throughout a surgical provider’s training and career.http://journals.lww.com/10.1097/AS9.0000000000000518
spellingShingle Adela Wu, MD
Sarah E. Bradley, PhD, MPH, CPH
C. Ann Vitous, MA, MPH
M. Andrew Millis, MD, MPH
Pasithorn A. Suwanabol, MD, MS
“It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
Annals of Surgery Open
title “It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
title_full “It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
title_fullStr “It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
title_full_unstemmed “It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
title_short “It’s Traumatic for All of Us”: A Qualitative Analysis of Providers Caring for Seriously Ill Veterans With Surgical Conditions
title_sort it s traumatic for all of us a qualitative analysis of providers caring for seriously ill veterans with surgical conditions
url http://journals.lww.com/10.1097/AS9.0000000000000518
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