Assessing Moral Distress in Social Workers: A Systematic Review of the Literature

Disciplines

Medicine and Health Sciences | Social Work

Abstract (300 words maximum)

Introduction/background: Moral distress is a form of psychological distress caused by experiences which are in violation of a person’s deeply held moral beliefs. This may include situations where the individual acts in a way that is in violation of their moral beliefs, but also situations where they witness and do not stop such actions. The topic has been studied in first responders and military populations (often under the term moral injury) and in nurses (as moral distress). Social workers likely experience moral distress; however, it has been understudied in that population. Given the unique context of social work and the negative effects of moral distress, the experiential dimensions and etiologies of moral distress in social work require further study. We therefore undertook a systematic review of the literature on moral distress in social workers, focusing on the definitions of moral distress used in the field.

Method: Our initial data extraction included 1,074 articles from databases such as Psychinfo, Applied Social Sciences Index & Abstracts (ASSIA), Social Services Abstracts, International Bibliography of the Social Sciences (IBSS), Social Sciences Citation Index (SSCI), Google Scholar, and Web of Science (WOS).

Results: After deduplication and exclusion processes, 54 articles were included for full text review. 10 different definitions were employed, primarily drawing from the definitions given by Jameton and Weinberg.

Conclusion: The generally shared definitions present across the literature indicate that the field of social work is beginning to coalesce on a shared understanding of this key construct, but there is still some definitional variability. Given the complexities of measuring moral distress and distinguishing it from other psychological distress constructs in social workers, developing a clear, shared definition of this key construct is a matter of both scientific and practical urgency for the field of social work.

Academic department under which the project should be listed

WCHHS - Health Promotion and Physical Education

Primary Investigator (PI) Name

Matthew Lyons

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Assessing Moral Distress in Social Workers: A Systematic Review of the Literature

Introduction/background: Moral distress is a form of psychological distress caused by experiences which are in violation of a person’s deeply held moral beliefs. This may include situations where the individual acts in a way that is in violation of their moral beliefs, but also situations where they witness and do not stop such actions. The topic has been studied in first responders and military populations (often under the term moral injury) and in nurses (as moral distress). Social workers likely experience moral distress; however, it has been understudied in that population. Given the unique context of social work and the negative effects of moral distress, the experiential dimensions and etiologies of moral distress in social work require further study. We therefore undertook a systematic review of the literature on moral distress in social workers, focusing on the definitions of moral distress used in the field.

Method: Our initial data extraction included 1,074 articles from databases such as Psychinfo, Applied Social Sciences Index & Abstracts (ASSIA), Social Services Abstracts, International Bibliography of the Social Sciences (IBSS), Social Sciences Citation Index (SSCI), Google Scholar, and Web of Science (WOS).

Results: After deduplication and exclusion processes, 54 articles were included for full text review. 10 different definitions were employed, primarily drawing from the definitions given by Jameton and Weinberg.

Conclusion: The generally shared definitions present across the literature indicate that the field of social work is beginning to coalesce on a shared understanding of this key construct, but there is still some definitional variability. Given the complexities of measuring moral distress and distinguishing it from other psychological distress constructs in social workers, developing a clear, shared definition of this key construct is a matter of both scientific and practical urgency for the field of social work.