AI Insight
This qualitative study examined moral distress among 15 Canadian public health workers from nursing, social work, medicine, and dietetics through in-depth interviews conducted in 2023. Four main sources of moral distress were identified: systemic powerlessness, political and ideological overreach, unethical work environments, and undervalued expertise. The study found that moral distress existed before COVID-19 but intensified during the pandemic, with practitioners' years of experience and demographic diversity affecting how they navigated these challenges.
Why it matters
Understanding sources of moral distress in public health workers is critical for developing targeted support strategies and preventing staff attrition during Canada's ongoing healthcare crisis. Identifying these specific stressors can inform organizational and policy interventions to retain experienced public health practitioners.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Aims Moral distress has been studied across many health arenas; however, public health has often been overlooked. Canada is facing a healthcare crisis with a significant number of staff leaving the healthcare field. This study explores the experiences of moral distress in public healthcare practitioners across Canada. Better understanding these experiences can provide insights into how to support staff and prevent attrition in public health. Methods This was a cross-sectional qualitative study. Fifteen in-depth interviews were conducted between May and July 2023, through remote and in person methods. Participants were from nursing, social work, medicine, and dietetics, all working in public health across Canada. Iterative thematic analysis was used. Emergent themes were compared within and across data sets and by participant age and years of experience. Results/Findings Experiences that contributed to moral distress included systemic powerlessness, political and ideological overreach, unethical work environments and undervalued expertise. Years of experience and diversity in gender and ethnicity impacted how practitioners navigated moral distress. Experiences where practitioners felt actions went against their values increased during the pandemic, contributing to moral injury. Conclusions This study situates the unique position of public health within the health system and explores experiences of moral distress both during and outside the COVID-19 pandemic. While the pandemic brought the concept of moral distress to the forefront of many peoples minds, these experiences existed prior. Addressing the underlying causes will contribute to establishing approaches to support public health practitioners suffering from moral distress and injury.
Source: Individual and system causes of moral distress experienced by public health practitioners in Canada