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Title: Systematic scoping review on moral distress among physicians
Authors: Quek, Chrystie Wan Ning
Ong, Ryan Rui Song
Wong, Ruth Si Man
Chan, Sarah Wye Kit
Chok, Amanda Kay-Lyn
Shen, Grace Shen
Teo, Andrea York Tiang
Panda, Aiswarya
Burla, Neha
Wong, Yu An
Chee, Ryan Choon Hoe
Loh, Caitlin Yuen Ling
Lee, Kun Woo
Tan, Gabrielle Hui Ning
Leong, Ryan Emmanuel Jian
Koh, Natalie Song Yi
Ong, Yun Ting
Chin, Annelissa Mien Chew 
Chiam, Min
Lim, Crystal 
Zhou, Xuelian Jamie 
Ong, Simon Yew Kuang 
Ong, Eng Koon 
Krishna, Lalit Kumar Radha 
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
medical education & training
mental health
education & training (see medical education & training)
Issue Date: Sep-2022
Citation: Quek, Chrystie Wan Ning, Ong, Ryan Rui Song, Wong, Ruth Si Man, Chan, Sarah Wye Kit, Chok, Amanda Kay-Lyn, Shen, Grace Shen, Teo, Andrea York Tiang, Panda, Aiswarya, Burla, Neha, Wong, Yu An, Chee, Ryan Choon Hoe, Loh, Caitlin Yuen Ling, Lee, Kun Woo, Tan, Gabrielle Hui Ning, Leong, Ryan Emmanuel Jian, Koh, Natalie Song Yi, Ong, Yun Ting, Chin, Annelissa Mien Chew, Chiam, Min, Lim, Crystal, Zhou, Xuelian Jamie, Ong, Simon Yew Kuang, Ong, Eng Koon, Krishna, Lalit Kumar Radha (2022-09). Systematic scoping review on moral distress among physicians. BMJ OPEN 12 (9). ScholarBank@NUS Repository.
Abstract: Background Concepts of moral distress (MD) among physicians have evolved and extend beyond the notion of psychological distress caused by being in a situation in which one is constrained from acting on what one knows to be right. With many accounts involving complex personal, professional, legal, ethical and moral issues, we propose a review of current understanding of MD among physicians. Methods A systematic evidence-based approach guided systematic scoping review is proposed to map the current concepts of MD among physicians published in PubMed, Embase, PsycINFO, Web of Science, SCOPUS, ERIC and Google Scholar databases. Concurrent and independent thematic and direct content analysis (split approach) was conducted on included articles to enhance the reliability and transparency of the process. The themes and categories identified were combined using the jigsaw perspective to create domains that form the framework of the discussion that follows. Results A total of 30 156 abstracts were identified, 2473 full-text articles were reviewed and 128 articles were included. The five domains identified were as follows: (1) current concepts, (2) risk factors, (3) impact, (4) tools and (5) interventions. Conclusions Initial reviews suggest that MD involves conflicts within a physician's personal beliefs, values and principles (personal constructs) caused by personal, ethical, moral, contextual, professional and sociocultural factors. How these experiences are processed and reflected on and then integrated into the physician's personal constructs impacts their self-concepts of personhood and identity and can result in MD. The ring theory of personhood facilitates an appreciation of how new experiences create dissonance and resonance within personal constructs. These insights allow the forwarding of a new broader concept of MD and a personalised approach to assessing and treating MD. While further studies are required to test these findings, they offer a personalised means of supporting a physician's MD and preventing burn-out.
Source Title: BMJ OPEN
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2022-064029
Appears in Collections:Staff Publications

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