Understanding the Coping Mechanisms of Intensive Care Unit Nurses to Manage Moral Distress: Insights from Content Analysis

Abstract

Background: Moral distress is a significant challenge faced by nurses in Pakistan, impacting their decision-making and patient care. A study was conducted to explore the coping strategies used by intensive care unit nurses in Koohi Goth Women Hospital and Atia General Hospital, Karachi, Pakistan to address moral distress.
Methodology: The study was conducted with nurses working in intensive care units of Koohi Goth Women Hospital and Atai General Hospital. The researchers used purposive sampling to select 17 eligible nurses and conducted in-depth, individual, semi-structured interviews with them. The data was analyzed using Graneheim and Lundman's 6-step content analysis method, and data management was done using MAXQDA software version 20.The study reporting followed the COREQ checklist.
Results: The study found that nurses employed both desirable and less desirable copingstrategies. Desirable strategies included compensation (e.g., discussing ethical issues withcolleagues, seeking support) and rejuvenation (e.g., taking breaks, engaging in self-care).Less desirable strategies involved indifference over time, escape (e.g., avoiding difficultsituations), and concealment (e.g., hiding ethical concerns).
Conclusion: Factors contributing to the use of less desirable strategies included lack ofsupport from hospital management, poor communication among colleagues, the need tomaintain hierarchy, fear of reprimand, and a sense of powerlessness.