Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic.

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Abstrakt

Tytuł:: Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic.
Autorzy:: Sukhera J; Departments of Psychiatry/Paediatrics and Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. .
Kulkarni C; Hospital for Sick Children (SickKids), Department of Psychiatry, University of Toronto, Toronto, Canada.
Taylor T; Department of Obstetrics and Gynecology and Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Źródło:: Perspectives on medical education [Perspect Med Educ] 2021 Aug; Vol. 10 (4), pp. 222-229. Date of Electronic Publication: 2021 Apr 29.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 2023- : [London] : Ubiquity Press
Original Publication: [Houten] : Bohn Stafleu van Loghum
MeSH Terms:: COVID-19*
Internship and Residency*
Mental Health*
Pandemics*
Physicians/*ethics
Social Discrimination/*ethics
Stress, Psychological/*etiology
Canada ; Ethics, Medical ; Faculty, Medical ; Female ; Health Equity ; Humans ; Male ; Morals ; Physicians/psychology ; Policy ; Power, Psychological ; Qualitative Research ; SARS-CoV-2 ; Social Discrimination/psychology ; Social Justice ; Vulnerable Populations
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Contributed Indexing:: Keywords: COVID-19; Marginalized populations; Moral distress; Professional identity formation; Stigma
Entry Date(s):: Date Created: 20210429 Date Completed: 20210902 Latest Revision: 20210902
Update Code:: 20240104
PubMed Central ID:: PMC8082743
DOI:: 10.1007/s40037-021-00663-y
PMID:: 33914288
: Czasopismo naukowe

Pełny tekst

Introduction: The COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. An improved understanding of such experiences may provide insights into how to prepare future physicians to improve health equity.
Methods: Utilizing constructivist grounded theory methodology, 22 participants from across Canada including 17 resident physicians from diverse specialties and 5 faculty members were recruited for semi-structured interviews from April-June 2020. Data were analyzed using constant comparative analysis.
Results: Results describe a distinctive form of moral distress called structural distress, which centers upon the experience of powerlessness leading resident physicians to go above and beyond the call of duty, potentially worsening their psychological well-being. Faculty play a buffering role in mitigating the impact of structural distress by role modeling vulnerability and involving residents in policy decisions.
Conclusion: These findings provide unique insights into teaching and learning about the care of structurally vulnerable populations and faculty's role related to resident advocacy and decision-making. The concept of structural distress may provide the foundation for future research into the intersection between resident well-being and training related to health equity.
(© 2021. The Author(s).)

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