Moral distress in Orthopedic ward of Imam Khomeini Hospital: A qualitative study

Moral distress is one of the issues facing the medical staff; means the inability of an individual to act on internal and professional values ​​due to internal and external pressures. Healthcare professionals may face challenging situations where they have ethical doubts about the rightness or wrongness of decisions; While feeling helpless in the face of changing circumstances that they consider immoral. Moral distress is recognized as one of the main causes of burnout syndrome among the medical staff. This study was performed to investigate the moral distress of the Orthopedic ward of Imam Khomeini Hospital.

Methods and Materials: 

This qualitative study was performed by content analysis through semi-structured face-to-face interviews with the participation of physicians, orthopedic residents and nurses of the Orthopedic ward of Imam Khomeini Hospital. The interviews were typed, coded and categorized carefully. Then the similar codes were placed in the same classes and subcategories.

23 interviews, 18 subclasses, 7 classes and 3 themes were formed: Care challenges, communication challenges of the treatment team, and educational challenges.

The results indicated the existence of various moral challenges, which affected the patient and the staff and caused distress, frustration and dissatisfaction. Addressing and managing these challenges raised the need for serious measures in regulating the health care system, job responsibilities, and improving interpersonal relationships. Recognizing the moral distress in system can be effective in planning and reforming the management and communication structure and ultimately improving the quality of care and patient`s outcomes.