1. Αποθετήριο Παραδοτέων Υποτρόφων Δράσεων ΕΣΠΑ Τριτοβάθμιας Εκπαίδευσης 2017-2023
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Τύπος:	Άρθρο σε επιστημονικό περιοδικό
Τίτλος:	Moral distress among neonatologists working in neonatal intensive care units in Greece: a qualitative study
Μέλος ερευνητικής ομάδας:	[EL] Δεληγιάννη, Μαρία[EN] Deligianni, Maria [EL] Τζητηρίδου, Μαρία[EN] Tzitiridou, Maria [EL] Δρόσου - Αγακίδου, Βασιλική[EN] Drossou - Agakidou, Vasiliki [EL] Ταρλατζής, Βασίλειος[EN] Tarlatzis, Basil
Επικεφαλής ερευνητικής ομάδας:	[EL] Βούλτσος, Πολυχρόνης[EN] Voultsos, Polychronis
Ημερομηνία:	08/03/2023
Περίληψη:	Background: Working as a neonatologist in a neonatal intensive care unit (NICU) is stressful and involves ethically challenging situations. These situations may cause neonatologists to experience high levels of moral distress, especially in the context of caring for extremely premature infants (EPIs). In Greece, moral distress among neonatologists working in NICUs remains understudied and warrants further exploration. Methods: This prospective qualitative study was conducted from March to August 2022. A combination of purposive and snowball sampling was used and data were collected by semi-structured interviews with twenty neonatologists. Data were classified and analyzed by thematic analysis approach. Results: A variety of distinct themes and subthemes emerged from the analysis of the interview data. Neonatologists face moral uncertainty. Furthermore, they prioritize their traditional (Hippocratic) role as healers. Importantly, neonatologists seek third-party support for their decisions to reduce their decision uncertainty. In addition, based on the analysis of the interview data, multiple predisposing factors that foster and facilitate neonatologists' moral distress emerged, as did multiple predisposing factors that are sometimes associated with neonatologists' constraint distress and sometimes associated with their uncertainty distress. The predisposing factors that foster and facilitate neonatologists' moral distress thus identified include the lack of previous experience on the part of neonatologists, the lack of clear and adequate clinical practice guidelines/recommendations/protocols, the scarcity of health care resources, the fact that in the context of neonatology, the infant's best interest and quality of life are difficult to identify, and the need to make decisions in a short time frame. NICU directors, neonatologists' colleagues working in the same NICU and parental wishes and attitudes were identified as predisposing factors that are sometimes associated with neonatologists' constraint distress and sometimes associated with their uncertainty distress. Ultimately, neonatologists become more resistant to moral distress over time. Conclusions: We concluded that neonatologists' moral distress should be conceptualized in the broad sense of the term and is closely associated with multiple predisposing factors. Such distress is greatly affected by interpersonal relationships. A variety of distinct themes and subthemes were identified, which, for the most part, were consistent with the findings of previous research. However, we identified some nuances that are of practical importance. The results of this study may serve as a starting point for future research.
Γλώσσα:	Αγγλικά
Σελίδες:	18
DOI:	10.1186/s12887-023-03918-1 10.1186/s12887-024-04802-2
ISSN:	1471-2431
Θεματική κατηγορία:	[EL] Παιδιατρική, Νεογνολογία και Υγεία του παιδιού[EN] Pediatrics, Perinatology and Child Health [EL] Ηθική[EN] Ethics
Λέξεις-κλειδιά:	Παιδιατρική; Νεογνολογία; Βιοηθική; Moral distress; Constraint distress; Uncertainty distress; Neonatologists; Neonatal Intensive Care Units (NICUs); Extremely Premature Infants (EPIs); Resuscitation decisions; Medical futility decisions
Κάτοχος πνευματικών δικαιωμάτων:	© The Author(s) 2023
Όροι και προϋποθέσεις δικαιωμάτων:	Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Διατίθεται ανοιχτά στην τοποθεσία:	https://pubmed.ncbi.nlm.nih.gov/38711097/
Ηλεκτρονική διεύθυνση του τεκμηρίου στον εκδότη:	https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-03918-1 https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04802-2
Ηλεκτρονική διεύθυνση περιοδικού:	https://bmcpediatr.biomedcentral.com/
Τίτλος πηγής δημοσίευσης:	BMC Pediatrics
Τεύχος:	1
Τόμος:	23 24
Σελίδες τεκμηρίου (στην πηγή):	Article no 114 Article no 312
Σημειώσεις:	ΣΧΕΤΙΖΕΤΑΙ ΜΕ POSTER ΠΟΥ ΠΑΡΟΥΣΙΑΣΤΗΚΕ ΣΕ ΔΙΕΘΝΕΣ ΣΥΝΕΔΡΙΟ ΤΗΣ ΕΥΡΩΠΑΪΚΗΣ ΕΤΑΙΡΕΙΑΣ ΠΑΙΔΙΑΤΡΙΚΗΣ ΚΑΙ ΝΕΟΓΝΙΚΗΣ ΕΝΤΑΤΙΚΗΣ ΘΕΡΑΠΕΙΑΣ ESPNIC23, ΑΘΗΝΑ, ΙΟΥΝΙΟΣ, 2023 Correction to to include the funder in the Funding statement: 1. Deligianni M, Voultsos P, Tzitiridou-Chatzopoulou MK, et al. Correction: Moral distress among neonatologists working in neonatal intensive care units in Greece: a qualitative study. BMC Pediatr. 2024;24:312. https://doi.org/10.1186/s12887-024-04802-2. This research was cofinanced by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014–2020» in the context of the project “Qualitative research on doctors’ moral distress and parents’ moral distress and moral schism in neonatal intensive care units” (MIS 5047889).”
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