Healthcare professionals experience moral distress when they cannot act based on their moral beliefs because of perceived constraints. Moral distress prevalence is high among critical care (ICU) clinicians but varies significantly between and within professions.
How can the inter-individual variability in moral distress of Canadian ICU physicians be explained to inform future system-based interventions?
We analyzed 135 free-text comments written by 83 of the 225 ICU physicians who participated in an online cross-sectional wellness survey. An inter-disciplinary team of five investigators completed the thematic analysis of anonymized survey comments according to published guidelines.
Physicians identified contextual and relational factors that contributed to moral distress and work-related stress. Combined sources of distress created high work-related demands that were not always matched by equally high resources or mitigated by work-related rewards. An imbalance between demands and rewards could lead to undesirable individual and collective consequences.
Moral distress is variably experienced by ICU physicians and linked to contextual and relational factors. Future studies should evaluate modifiable factors such as team interactions and the role of professional rewards as mitigators of distress to bring new insights into strategies to improve ICU clinician wellness and patient care.

Copyright © 2022. Published by Elsevier Inc.