Moral distress in nursing practice in Malawi

• Published in: Nursing ethics Vol. 19; no. 2; pp. 196 - 207
• Main Authors: Maluwa, Veronica Mary, Andre, Judy, Ndebele, Paul, Chilemba, Evelyn
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2012; SAGE PUBLICATIONS, INC
• Subjects: Acquired immune deficiency syndrome; Adaptation, Psychological; Adult; AIDS; Anecdotes as Topic; Conflict (Psychology); Councils; Data analysis; Data collection; Ethics; Female; Health; Health Knowledge, Attitudes, Practice; HIV; Human immunodeficiency virus; Humans; Interprofessional Relations - ethics; Interviews; Interviews as Topic; Malawi; Midwifery; Moral aspects; Morals; Nurse Administrators - ethics; Nurse Administrators - psychology; Nurse Administrators - standards; Nurses; Nurses - psychology; Nurses - statistics & numerical data; Nurses' Aides - psychology; Nurses' Aides - statistics & numerical data; Nursing; Nursing Administration Research; Nursing care; Pandemics; Patients; Personnel Turnover; Physician-Nurse Relations; Psychological distress; Qualitative Research; Social Support; Stress, Psychological - etiology; Stress, Psychological - psychology; Surveys and Questionnaires; Workforce planning; Malawi; United States > US; Michigan; moral distress; practicing nurses; nursing practice; Malawi; nursing ethics
• ISSN: 0969-7330; 1477-0989
• DOI: 10.1177/0969733011414968

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care.