Moral Distress in Pediatric Physician Trainees Caring for Patients With Neurologic Conditions.

Abstract

ObjectiveMoral distress is psychological pain evoked by the inability to act according to ones values. Characterization of moral distress among pediatric trainees caring for patients with neurologic conditions is lacking. This study examines moral distress accordingly.MethodsCross-sectional survey at a pediatric quaternary care hospital. Trainees responded in the context of caring for children with neurologic conditions. Survey included the Measure of Moral Distress for Healthcare Professionals (MMD-HP), featuring items corresponding with moral distress causes: system, patient, team. Two items adapted from the Maslach Burnout Inventory, questions evaluating moral distress mitigation, and a free text section were featured. Responses were analyzed for all respondents and subspecialty groups.ResultsParticipant response rate was 33% (80 of 244). Most were familiar with moral distress but recommended additional education. All experienced moral distress and associated burnout in the specified context. Patient-related situations were most distressing. No significant difference in overall MMD-HP scores was noted between subspecialty groups. Debriefing with other providers was projected to best address moral distress.ConclusionsPediatric trainees caring for patients with neurologic conditions are at risk of moral distress and associated burnout. Patient-related situations most contributed to moral distress, specifically the pursuit of life-sustaining care perceived to be futile.