Unit:
ΠΜΣ Κλινική Παιδιατρική και Νοσηλευτική - ΈρευναLibrary of the School of Health Sciences
Author:
Feizidou Paraskevi
Supervisors info:
Ευαγγέλου Ελένη, Καθηγήτρια, Νοσηλευτική, Πανεπιστήμιο Δυτικής Αττικής
Κουτελέκος Ιωάννης, Επίκουρος Καθηγητής, Νοσηλευτική, Πανεπιστήμιο Δυτικής Αττικής
Τζουμάκα-Μπακούλα Χρυσάνθη, Ομότιμη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Διερεύνηση του ηθικού του ηθικού αδιεξόδου στο ιατρονοσηλευτικό προσωπικό παιδιατρικής ΜΕΘ
Translated title:
Study of moral distress in pediatric intensive care doctors and nurses
Summary:
Introduction:
The use of technology in Intensive Care Units has resulted in the decrease of death rates of patients, however, it is the cause of several problems. The majority of these problems is related to the decisions that have to be made on the continuation of support for several patients and the consequences on the psychological status of healthcare professionals.
Objective:
The purpose of this research is to study the moral distress of nurses and doctors working in Paediatric Intensive Care Units in relation to offering «futile treatment»
Methods:
This study is cross-sectional. The study group consists of 121 nurses and doctors working in all public Paediatric Intensive Care Units in Greece. For the collection of data, a specially modified questionnaire was used for the study purposes, based on work experience of the members of the research group and the recent scientific literature on the subject. For the analysis of the results, Statistical Package for Social Sciences (SPSS) ver.24 was used.
For the investigation of correlation between independent variables Pearson x2 was used, and as a level of significance for all testing p<0,05 was used.
Results:
The vast majority of participants (81.8%) have applied futile treatments, with unrealistic objectives and 77.7% of them believed that they did not contribute to treatment but prolonged the course of death. A percentage of 81.8% agree that the continuation of futile treatment must be a joined decision of the entire therapy group and there has been statistically significant correlation (p=0,001) to the occupation of the participants since this was supported by the 97.8% of doctors and 72.4% of nurses. For the 85.1% of participants, futile treatment can be limited by provision of correct information and building of trusting relationship between the child, the family and the treatment group. There is also strong correlation to this subject (p=0,001), as 100% of doctors and 76.3% of nurses agree. The 75.2% of the participants agree that concerns for possible legal implications may affect the treatment plan in patients with no life expectancy. The high financial cost of futile treatments should be taken into consideration when deciding to continue life support (58.7%). The years of working experience play a decisive role since, the participants that work for more than 21 years emphatically agree with this opinion (p=0,002).
Conclusion:
It is clear that concerns that induce moral distress in PICU healthcare professionals exist and relate to futile treatment. Very often, these concerns are the cause of conflict between members of the therapy group resulting in significant psychological burden.
Main subject category:
Health Sciences
Keywords:
PICU, Futile therapy, End of life decisions, Moral distress, Withholding, Withdrawing
