Evidence map›Paper›PMID 42732022›Full record

ArticleAnnals of surgical oncology2026

Prevalence and Risk Factors of Moral Distress Among Surgeons Specialized in Oncology Care.

Jennifer H Chen, Heather A Lillemoe, Mohamed Ait Aiss, Elizabeth G Grubbs, Ashley Holder, Jolyn Taylor, Ching-Wei Tzeng, Brian K Bednarski, Stephen G Swisher, Christopher P Scally

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Jennifer H ChenDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Heather A LillemoeDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Mohamed Ait AissDepartment of Education and Training Division, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Elizabeth G GrubbsDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ashley HolderDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jolyn TaylorDivision of Surgery, Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ching-Wei TzengDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Brian K BednarskiDivision of Surgery, Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Stephen G SwisherDivision of Surgery, Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Christopher P ScallyDivision of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. CPScally@mdanderson.org.

Funding

Collaboration for Leadership in Applied Health Research and Care - Greater Manchester P30 CA016672Collaboration for Leadership in Applied Health Research and Care - Greater Manchester T32 CA 009599
6 · The paper itself

Abstract

backgroundMoral distress, the negative emotions associated with the inability to do the right thing due to imposed constraints, is prevalent among health care workers but underexplored among surgeons.

methodsThis was a cross-sectional study in October 2024 using the Measure of Moral Distress for Healthcare Professionals (MMD-HP) survey distributed to the Division of Surgery at a comprehensive cancer center. Descriptive statistics as well as Mann-Whitney U, Kruskal-Wallis, and Fisher's exact tests were used to compare group differences.

resultsThe overall response rate was 19.3 % (45/233). Among the respondents, 48.9 % were female (n = 22), 24.4 % were racial and ethnic minorities % (n = 11), and 28.9 % were trainees (n = 13). The top surgical specialties included surgical oncology (n = 22, 48.9 %), breast surgical oncology (n = 7, 15.6 %), and gynecologic oncology (n = 8, 17.8 %). Of the respondents, 28.9 % (n = 13) practiced in an acute/intensive care setting, and 26.7 % (n = 12) received previous palliative care training. All the respondents reported moral distress (median, MMD-HP score, 61; interquartile range [IQR], 33-86). Because of moral distress, 24 % (n = 11) considered leaving or had left a clinical position, and 8.9 % (4) considered leaving their current position. Those who intended to leave had significantly higher scores than those who did not (p < 0.05). The MMD-HP scores did not differ significantly by demographics, trainee versus faculty role, surgical subspecialty, or palliative care experience. The top sources of moral distress centered around patient- and team-level interactions.

conclusionIn this cohort of surgeons specialized in oncology care, moral distress was highly prevalent and driven by patient-, team-, and system-level factors. These findings may help inform the development of interventions aimed at mitigating moral distress for current and future generations of surgeons.

Indexed as

BurnoutMMD-HP scoreMoral distressMoral injurySurgical oncologistsSurgical trainees

Identifiers

PMID42732022

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.