Abstrakt

Moral distress and educational level in medical officers at National Cancer Institute Sri Lanka

Amjed Duwegoda

Background: Moral distress is emotional stress experienced by health care workers due to ethically conflicting situations while caring for patients. Medical officers providing care for cancer patients at National Cancer Institute Sri Lanka may encounter moral distress. Educational level of the medical officers can influence their moral distress. Objectives: The main objective of this study is to describe the relationship between moral

distress and level of education in medical officers working in National Cancer Institute Sri Lanka. Method: A cross sectional survey carried out by a structured self-administered questionnaire using moral distress scale adapted to the study context with the educational level questionnaire. A total of 160 medical officers working in the national cancer institute were included in the study. Results: The survey was completed by 132 medical officers and 77 of them had very mild or no moral distress and 55 of them had mild to moderate moral distress. Among the medical officers had very mild or no moral distress 35.1% of them had post graduate qualifications apart from their basic medical degree while only a 18.2% of medical officers had post graduate qualifications among the very mild or no moral distress group. In the assessment of the association of the level of moral distress with the education level, a statistically significant difference (p=0.33) was noted and further it is evident that this difference arises due to the low percentage of (27%) individuals with post graduate qualifications in the mild to moderate moral distress group. Conclusion: A significant association of the level of moral distress with educational level

was noted and those with postgraduate qualifications have low levels of moral distress in comparison with those without post graduate qualifications. Moral distress occurs when the doctor’s perception of ethically suitable action cannot be implemented due to situational constrains at health care settings (Ferrell, 2006). Moral distress can also be defined as emotional stress of the health care worker due to ethically conflicting situations (Kälvemark, Höglund, Hansson, Westerholm, & Arnetz, 2004).The study was conducted in the National Cancer Institute Maharagama (NCIM), in Sri Lanka. The NCIM is the premium centre for cancer care in Sri Lanka. The grade medical officers working at NCIM were included in the study as the grade medical officers play a key role in treating cancer patients. The purpose of the study was to assess the prevalence of moral distress. A descriptive cross sectional study was conducted

among all grade medical officers working in clinical areas of the NCIM. A structured self-administered questionnaire was used to collect data. A total of 160 grade medical officers were included in the study and 132 questionnaires were returned after completion of the questionnaire. The response rate was 82.5%. The prevalence of moral distress among the study population was 91.2% while 3.8% had severe moral distress and 9.8% had no moral distress. The majority of the grade medical officers had very mild moral distress (48.5%). Mild moral distress was seen among 33.3% of the grade medical officers and 4.5% of the grade medical officers had moderate moral distress. The study revealed a prevalence of 91.2% moral distress among grade medical officers at NCIM. However the majority of the grade medical officers had only very mild moral distress.