Factors influencing healthcare professionals’ moral distress: A descriptive qualitative analysis

<b>Background:</b> The Measure of Moral Distress - Healthcare Professionals (MMD-HP) is a 27-item survey that quantifies moral distress. The MMD-HP was distributed to healthcare professionals (HPs), and analysis of a free-text response item revealed information-rich descriptions of morally distressing situations. <b>Research question:</b> What are HPs' perceptions of their experiences of morally distressing situations? <b>Research design:</b> A descriptive, qualitative approach explored respondents' free-text responses to the following open-ended response item: "If there are other situations in which you have felt moral distress, please write and score them here." <b>Participants and research context:</b> Eligible participants were HPs (<i>N</i> = 8206) working in a large, multi-site healthcare system located in a major, urban city in the Southeastern United States. <b>Ethical considerations:</b> The Institutional Review Board provided approval for this research. A survey preamble supplied information, and consent was presumed with survey completion. <b>Findings:</b> Three themes were identified from 282 free-text responses: Theme 1: Compromised Quality of Care, Theme 2: Hostile Work Environment, and Theme 3: Ineffective Leadership. <b>Conclusions:</b> This study is unique because it provided in-depth qualitative analysis of morally distressing situations in a free-text response item across a wide array of HPs within multiple settings. Responses revealed that moral distress impacted the quality of patient care and provided descriptions of powerlessness to act.