Critical care staff who are spiritual may suffer from increased moral distress

1. In this scoping review, critical care staff who were spiritual experienced greater moral distress due to a lack of resources and their perceived moral standards.

2. Furthermore, a lack of institutional support in accessing spirituality resources contributed in part to their moral distress.

Evidence Rating Level: 1 (Excellent)

Due to their work environment, critical care staff experience high levels of moral distress which negatively impacts their health. Though spirituality plays an important role in overall wellness, current studies have not explored the association between spirituality, moral distress, and resilience in this population. As a result, the objective of the present scoping review was to evaluate the influence of spirituality on moral distress and resilience in critical care staff.

Of 242 identified records, 13 (n=4057 individuals) studies were included from various databases from 2017 to 2021. Studies were included If their objective was to evaluate the impact of spirituality on moral distress in critical care staff. Studies such as editorials, points of view, and letters were excluded. The review was performed using PRISMA guidelines and used the five-step framework proposed by Arksey and O’Malley. Study quality was assessed using the Standard Quality Assessment Criteria. The primary outcome was moral distress and resilience in critical care staff.

The results demonstrated that critical care staff who were spiritual had increased risk of moral distress. Reasons for the increased risk of moral distress in spiritual critical care staff included a perception of higher moral standards, and issues with accessing spirituality resources. Furthermore, it was found that critical care staff desired more institutional support in order to access spiritual interventions. Despite these results, the study was limited by inclusion of only studies primarily from the United States which may limit generalizability to critical care staff from other countries. Nonetheless, the present study demonstrated the need to implement additional strategies to support the well-being of critical care staff.

Click to read the study in Intensive and Critical Care Nursing

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