ArticleBMC nursing2026
Nursing care and moral distress among nordic nurses: a scoping review of ethical challenges in contemporary clinical practice.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMoral distress refers to situations in which nurses recognise the ethically appropriate action but are constrained from acting accordingly. Although widely studied internationally, moral distress has not been systematically mapped within Nordic healthcare contexts.
methodsA scoping review was conducted following Arksey and O’Malley’s framework and reported in accordance with PRISMA-ScR guidelines. PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus were searched (January–February 2024) for empirical studies published between 2015 and 2024 addressing moral distress or closely related ethical constructs among nurses in Nordic countries. Data were charted and synthesised using thematic analysis.
resultsThirteen studies met inclusion criteria. Across clinical settings, moral distress and related constructs were consistently associated with organisational constraints, relational tensions, and emotional strain. Insufficient staffing, time pressure, regulatory demands, and efficiency-oriented governance were frequently described as contributing to ethically challenging situations. Relational tensions, particularly in end-of-life care and complex patient–family interactions, were also prominent. Emotional consequences included rumination, troubled conscience, and reflections on professional sustainability. Considerable conceptual heterogeneity was identified across studies. DISCUSSION: In Nordic nursing research, moral distress is primarily articulated at the intersection of professional values and structural constraints within welfare-based healthcare systems. Greater conceptual clarity and longitudinal research are needed to strengthen cumulative knowledge in this field. CLINICAL TRIAL NUMBER: Not applicable.
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