Evidence map›Paper›PMID 38803245›Full record

ArticleBMJ open2024

Moral distress among physicians in Norway: a longitudinal study.

Ingrid Miljeteig, Reidun Førde, Karin Isaksson Rø, Fredrik Bååthe, Berit Horn Bringedal

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

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2citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ingrid MiljeteigBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway ingrid.miljeteig@uib.no.ORCID 0000-0001-5738-017X
Reidun FørdeCenter for Medical Ethics, University of Oslo Faculty of Medicine, Oslo, Norway.
Karin Isaksson RøInstitute for Studies of the Medical Profession, Oslo, Norway.
Fredrik BååtheInstitute for Studies of the Medical Profession, Oslo, Norway.
Berit Horn BringedalInstitute for Studies of the Medical Profession, Oslo, Norway.ORCID 0000-0002-4212-0639

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore and compare physicians' reported moral distress in 2004 and 2021 and identify factors that could be related to these responses.

designLongitudinal survey.

settingData were gathered from the Norwegian Physician Panel Study, a representative sample of Norwegian physicians, conducted in 2004 and 2021.

participants1499 physicians in 2004 and 2316 physicians in 2021.

main outcome measuresThe same survey instrument was used to measure change in moral distress from 2004 to 2021. Logistic regression analyses examined the role of gender, age and place of work.

resultsResponse rates were 67% (1004/1499) in 2004 and 71% (1639/2316) in 2021. That patient care is deprived due to time constraints is the most severe dimension of moral distress among physicians, and it has increased as 68.3% reported this 'somewhat' or 'very morally distressing' in 2004 compared with 75.1% in 2021. Moral distress also increased concerning that patients who 'cry the loudest' get better and faster treatment than others. Moral distress was reduced on statements about long waiting times, treatment not provided due to economic limitations, deprioritisation of older patients and acting against one's conscience. Women reported higher moral distress than men at both time points, and there were significant gender differences for six statements in 2021 and one in 2004. Age and workplace influenced reported moral distress, though not consistently for all statements.

conclusionIn 2004 and 2021 physicians' moral distress related to scarcity of time or unfair distribution of resources was high. Moral distress associated with resource scarcity and acting against one's conscience decreased, which might indicate improvements in the healthcare system. On the other hand, it might suggest that physicians have reduced their ideals or expectations or are morally fatigued.

Indexed as

PhysiciansAdultAgedAttitude of Health PersonnelFemaleHumansLogistic ModelsLongitudinal StudiesMaleMiddle AgedMoralsNorwayPsychological DistressSex FactorsStress, PsychologicalSurveys and Questionnairesburnout, professionaldecision makinghealth workforcehuman resource managementmedical ethicsrationing

Identifiers

PMID38803245
PMCPMC11129035

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.