Explaining the concept of moral distress in pediatric nurses: A hybrid concept analysis

Background: This study is necessary due to the lack of clarity regarding the various characteristics of moral distress.Objectives: The objective of this study is to present evidence on the concept of moral distress, its causes, symptoms, characteristics, consequences, and the strategies proposed by pediatric nurses, using a hybrid concept analysis.Methods: This research employed a hybrid concept analysis model based on Schwartz-Barcott and Kim's approach in three phases of theory, fieldwork, and final analysis to analyze the concept of Moral distress.In the theoretical stage, relevant articles in different databases, a combination of keywords related to "moral distress" and "pediatric nurse" was utilized in both Persian and English for studies published from 2014 to 2024.A total of 15 English and Persian texts were selected and analyzed.In the fieldwork stage, in-depth and semi-structured interviews were conducted with 12 nursing experts using purposive sampling.A final analysis was performed by combining the previous two stages in the final stage.Results: Main categories were extracted in the field of moral distress concept analysis in pediatric nurses, including Antecedent (Poor Teamwork, Communication, and Inadequate Human Resources and Equipment), Features (Moral Dilemma, Psychological Issues), and Consequences (Moral Courage, Burnout, Fear of Encountering Patients).Conclusion: Explaining the concept of moral dilemma leads to a better understanding of this issue and helps nurses to balance the difficulty of ethical decisions with meeting the patient's needs and managing their own emotions to improve the quality of patient care. Implications for Nursing and Midwifery Preventive Care This study provides more humane and realistic care for children By understanding this concept, nurses courageously face these situations and do what is right and ethical This analysis helps nurses express their concerns by creating a safe environment, leading to increased job satisfaction, personal growth, and improved quality of care