DETERMINANTS OF MORAL DISTRESS AMONG HEALTHCARE PROVIDERS WORKING IN ONCOLOGY DEPARTMENT, KENYATTA NATIONAL HOSPITAL, NAIROBI CITY COUNTY, KENYA
Abstract
Background: This study discusses the prevalence, causes and interrelationships of the causal factors and the coping mechanisms of the HCPs to moral distress in oncology departments.
The purpose of the study: A cross sectional study was conducted, using a proportionate stratified sampling method to take in the study sample representative and information was composed using a structured self- administered questionnaire. Descriptive analysis was done where frequencies and percentages were used to sum up grouped data while mean and standard deviation was used to summarize continuous data. Chi-square and Fischer’s exact test were used to investigate the factors associated with moral distress. Binary logistic regression was used to investigate the determinants of moral distress. Level of significance was investigated at 0.05. Statistical package for social sciences was used for analysis.
Results: The findings showed that, 56.6%(n =82) of the respondents were male. In investigating age group of study participants, 40.7%(n =59) were aged between 41 and 50 years. Marital status showed that 59.3%(n =86) of the participants were married. In investigating moral distress, that 37.9% (n =55) had no moral distress, 49%(n =71) had mild moral distress while 13.1%(n =19) had severe moral distress. The findings showed that participants with degree, (AOR =0.33, 95%CI:0.14 – 0.85, p =0.001), higher diploma, (AOR =0.22, 95%CI:0.10 – 0.49, p <001) and those with master’s level education, (AOR =0.16, 95%CI:0.04 – 0.51, p =0.010) were less likely to experience moral distress as likened to those with diploma level qualification. Those who had ≤2 years duration of experience (AOR =2.50, 95%CI:1.91 – 6.41, p =0.005). Those who were neutral on assertion that patients’ relatives have unrealistic expectations about them (OR =0.24, 95%CI:0.09 – 0.76, p =0.015), Those who agreed with the statement that patients’ relatives have unrealistic expectations about (AOR =3.88, 95%CI:1.05 – 14.35, p =0.042 and those who disagreed with the statement that there is autonomy in decision making (AOR =4.15, 95%CI: 1.16 – 14.81, p =0.028) were determinants of moral distress.
Conclusion and recommendations: The findings have showed that the burden of moral distress is high which warrants the need for healthcare providers to shape focus on their wellbeing. There is need to foster a culture of open communication where healthcare providers feel comfortable discussing moral distress and ethical challenges with colleagues, supervisors, and mentors.
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