Supervision, Moral Distress and Moral Injury Within Palliative Care—A Qualitative Study

Pia Geuenich, Lena Schlömer, Sonja Owusu-Boakye and Henrikje Stanze ()
Additional contact information
Pia Geuenich: Faculty of Social Sciences, Centre for Nursing Research and Counselling, University of Applied Sciences Bremen, Am Brill 2–4, 28195 Bremen, Germany
Lena Schlömer: Faculty of Social Sciences, Centre for Nursing Research and Counselling, University of Applied Sciences Bremen, Am Brill 2–4, 28195 Bremen, Germany
Sonja Owusu-Boakye: Faculty of Social Sciences, Centre for Nursing Research and Counselling, University of Applied Sciences Bremen, Am Brill 2–4, 28195 Bremen, Germany
Henrikje Stanze: Faculty of Social Sciences, Centre for Nursing Research and Counselling, University of Applied Sciences Bremen, Am Brill 2–4, 28195 Bremen, Germany

IJERPH, 2025, vol. 22, issue 7, 1-16

Abstract: The number of people requiring palliative care is increasing. This can result in moral and ethical conflicts that may lead to psychological distress and moral injury. (MI). Solutions are needed to counteract career abandonment—supervision (SV) could be one solution. This study examines the extent to which palliative care nurses link MI to their everyday experiences and whether SV can contribute to the identification and prevention of moral distress and MI. In addition, factors that influence the implementation of, participation in, and perception of SV are analyzed. A qualitative study design was chosen for the investigation, consisting of guided interviews, narrative-generating questions with seven participants working in palliative care, and participant observation with audio recording during two supervisions of two palliative care teams with 16 participants in total. The data was analyzed using qualitative content analysis according to Mayring. The results show differences in workload between acute and palliative care wards. Time pressure and hierarchical structures promote distress and MI and are particularly evident on acute wards. The interviewees described specific experiences of MI. In addition, factors were identified that influence participation in SV. The analysis of SV showed that workload is a key cause of moral distress and can have an impact on health. SV can be used for sensitization and exchange. Implementation and acceptance of SV depend on individual and structural factors. In palliative care, signs of moral distress are present and are specifically addressed in SV, which means that SV can be a tool for dealing with stressful situations.

Keywords: moral distress; moral injury; supervision; palliative care; hospice care; nurse (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/7/1156/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/7/1156/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:7:p:1156-:d:1706489

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().