Moral Distress and Other Wellness Measures in Canadian Critical Care Physicians.

Rationale Understanding the magnitude of moral distress and its associations may point to solutions. Objective To understand the magnitude of moral distress and other measures of wellness in Canadian critical care physicians, to determine any associations among these measures, and to identify potentially modifiable factors. Methods This was an online survey of Canadian critical care physicians whose email addresses were registered with either the Canadian Critical Care Society or the Canadian Critical Care Trials Group. We used validated measures of moral distress, burnout, compassion fatigue, compassion satisfaction, and resilience. We also measured selected individual, practice, and workload characteristics. Results Of the 499 physicians surveyed, 239 (48%) responded and there were 225 usable surveys. Respondents reported moderate levels of moral distress (107 + 59; mean + SD, maximum 432), one-third of respondents had considered leaving or had previously left a position due to moral distress, about one-third met criteria for burnout syndrome and a similar proportion reported medium-high levels of compassion fatigue. In contrast, about one-half of respondents reported a high level of compassion satisfaction and overall, respondents reported a moderate level of resilience. Each of the 'negative' wellness measures (moral distress, burnout, and compassion fatigue) was associated directly with each of the other 'negative' wellness measures, and inversely with each of the 'positive' wellness measures (compassion satisfaction and resilience), but moral distress was not associated with resilience. Moral distress was lower in respondents who were married or partnered compared to those who were not, and prevalence of burnout was lower in respondents who had been in practice for longer. There were no differences in any of the wellness measures between adult and pediatric critical care physicians. Conclusion Canadian critical care physicians report moderate levels of moral distress, burnout, and compassionate fatigue, and moderate-high levels of compassion satisfaction and resilience. We found no modifiable factors associated with any wellness measures. Further quantitative and qualitative studies are needed to identify interventions to reduce moral distress, burnout and compassion fatigue.