The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.
Moral distress experienced by community service providers of home health and social care in Ontario, Canada
Open accessAbstract
Moral distress occurs when one knows a morally correct action to take but feels powerless to act the way one believes is right. Moral distress has been studied in many contexts but there remains a gap in our understanding of the phenomenon as it manifests outside of hospital-based settings. The aim of this study was to explore the nature of the moral distress experience among community-based health and social care professionals working with older adults and their caregivers. Using a qualitative constructionist design, we interviewed 24 participants from a single health authority in southwestern Ontario, Canada. Participants were both urban and rurally based. Data were collected in the winter and summer of 2020 and analysed using Braun and Clarke's thematic analysis strategy. Three factors: reluctant clients, human resource shortages and system challenges, contributed to the creation of perceived morally precarious care plans, resulting in symptoms of moral distress. Study participants described frustration, guilt, anger, and grief at not being able to act consistently with their core values and provide the amount and/or quality of care their clients and unpaid caregivers deserved. We consider possible reasons for our finding that community service providers did not always respond to the consequences of moral distress symptoms in a manner similar to those in acute care contexts. Our findings suggest that study participants may have been able to cultivate moral resilience in the face of moral distress through the positive reframing of adversity and therefore maintain their overall sense of moral integrity.
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“Community service providers, including AS staff, have reported emotional and moral distress when system challenges prevent them from meeting client needs (Webber et al., 2022).”
From Acceptance and Commitment Therapy Tele-Counselling Program With Care Partners of Persons Living With Dementia: A Pilot Feasibility RCT. (2026) · cites this paper as Webber et al., 2022
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Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414
Lincoln, Y. S., Guba, E. G., & Pilotta, J. J. (1985) · International Journal of Intercultural Relations · doi:10.1016/0147-1767(85)90062-8 · Cited by 45,787
(2011) · Cited by 7,157
(2014) · Medical Entomology and Zoology · Cited by 6,828
Braun, V., & Clarke, V. (2021) · Qualitative Research in Sport, Exercise and Health · doi:10.1080/2159676x.2019.1704846 · Cited by 4,776
Terry, G., Hayfield, N., Clarke, V., & Braun, V. (2017) · The SAGE Handbook of Qualitative Research in Psychology · doi:10.4135/9781526405555.n2 · Cited by 2,448
Nursing practice, the ethical issues
(1985) · International Journal of Nursing Studies · doi:10.1016/0020-7489(85)90057-4 · Cited by 1,524
The SAGE Handbook of Qualitative Research in Psychology
Willig, C., & Rogers, W. S. (2017) · doi:10.4135/9781526405555 · Cited by 1,035
Moral Distress, Moral Residue, and the Crescendo Effect
Epstein, E. G., & Hamric, A. B. (2009) · The Journal of Clinical Ethics · doi:10.1086/jce200920406 · Cited by 917
Hamric, A. B., & Blackhall, L. J. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000254722.50608.2d · Cited by 816
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Research works printed but not linked: 1
- Brazil K., 2010, An examination of moral distress experienced by health care providers who provide community palliative care, Journal of Palliative Care, 26, 229
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Fostering moral resilience through moral case deliberation
Metselaar, S., & Molewijk, B. C. (2023) · Nursing Ethics · doi:10.1177/09697330231183085 · Cited by 18
“15,16 These emotions may vary according to cultures and contexts.”
BackgroundMoral Suffering in Frontline Social Care Workers: A Study of Moral Injury and Moral Distress
Harper, S., & Karypidou, A. (2024) · European Journal of Mental Health · doi:10.5708/ejmh.19.2024.0021 · Cited by 13
“MD’s protective factors include longer tenure, collaborative and supportive working environments, cooperation between colleagues and organizations, as well as being based in community rather than hospital settings (Hancock et al., 2020; Webber et al., 2021).”
BackgroundDelgado‐Ron, J. A., Tiwana, M. H., Mũrage, A., Morgan, R., Purewal, S., & Smith, J. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11377-2 · Cited by 9
Personal Support Work and Home Care in Ontario during the COVID-19 Pandemic
Hopwood, P., MacEachen, E., McAiney, C. A., & Tong, C. (2022) · Healthcare policy · doi:10.12927/hcpol.2022.26970 · Cited by 7
Experiencing Moral Distress Within the Intimate Partner Violence & Sexual Assault Workforce
Schrag, R. V., Fantus, S., Leat, S. R., Childress, S., & Wood, L. (2023) · Journal of Family Violence · doi:10.1007/s10896-023-00567-x · Cited by 6
“…studies from Finland (Mänttäri-van der Kuip, 2016), Norway (Østertun Geirdal et al., 2022), Israel (Lev & Ayalon, 2018), and Canada (Greason, 2020; Webber et al., 2021) demonstrate that insufficient resources, budget constraints, underfunded systems, overburdened caseloads, and poor…”
Metadata
- Authors
- Webber, J., Trothen, T. J., Finlayson, M., & Norman, K. E.
- Affiliations
- Queen's University (CA)
- Corresponding author
- Webber, Jodi
- Venue
- Health & Social Care in the Community
- Publisher
- Wiley
- Published
- 2021-09-28
- Volume
- 30
- Issue
- 5
- Pages
- e1662-e1670
- ISSN
- 0966-0410 (ISSN-L)
- 1365-2524
- OpenAlex
- W3204601405
- Cited by
- 15
- References
- 39
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 1
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Health & Social Care in the Community (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Ethics in Business and Education
- Keywords
- moral distress, community service providers, home health care, social care, older adults, informal caregivers, human resource shortage, moral resilience, moral integrity, care planning
- MeSH terms
- Aged, Humans, Morals, Ontario, Social Support, Social Welfare, Stress, Psychological, Qualitative Research
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