Secondary Logo


Larson, C.1; Crowe, L.2; Cross, J.3; Festa, M.4; Ganu, S.5; Jackson, H.6; Miles, F.7; Swil, K.8; Dryden-Palmer, K.9; Parshuram, C.9; Millar, J.10

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 42
doi: 10.1097/01.pcc.0000537441.91439.d6
Poster Discussion Abstracts

1Stollery Children’s Hospital, Pediatric Critical Care, Edmonton, Canada

2Lady Cilento Children’s Hospital, Pediatric Critical Care, Brisbane, Australia

3Princess Margaret Hospital, Pediatric Critical Care, Perth, Australia

4The Children’s Hospital at Westmead, Pediatric Critical Care, Sydney, Australia

5Women’s and Children’s Hospital, Pediatric Critical Care, Adelaide, Australia

6Royal Hobart Hospital, Pediatric Critical Care, Hobart, Australia

7Starship Children’s Hospital, Pediatric Critical Care, Auckland, New Zealand

8Sydney Children’s Hospital, Pediatric Critical Care, Sydney, Australia

9Hospital for Sick Children, Pediatric Critical Care, Toronto, Canada

10The Royal Children’s Hospital in Melbourne, Pediatric Critical Care, Melbourne, Australia

Back to Top | Article Outline

Aims & Objectives:

To measure moral distress in pediatric intensive care unit (PICU) health practitioners and its relationship with demographic factors, burnout and meaning in work.

Back to Top | Article Outline


Building on a pilot study, a survey of health practitioners was conducted in PICUs in Australia and New Zeala7nd. The main outcome was moral distress, measured with the Revised Moral Distress Scale (MDS-R) (range 0–336). Secondary outcomes were depersonalisation measured with the Maslach Burnout Inventory sub-scale (range 0–30) and meaning in work measured using questions from the Work and Meaning Inventory (range 0–30).

Back to Top | Article Outline


All PICUs in Australia and New Zealand participated (n=8). 673(95%) responses were analysable. The response rate was 60%. Respondents were nurses (RN, n=526, 78%), physicians (MD, n=112, 17%) and allied health (AH, n=34, 5%). Most respondents were female (83%), under 40 (62%) and full-time (65%). The median MDS-R score was 68(42–95), and 46% of respondents reported significant work-related moral distress. MDS-R scores differed by profession: RN 72.5(46–102), MD 59.5(36–76), AH 31(13–64) (p<0.001); by employment: full-time 70(44–99), part-time 65.5 (38.5–90) (p<0.001); and by sex: female 70(44–99), male 57.5(36–75.5) (p<0.001) which remained significant after adjusting for profession (p<0.001). Moral distress did not differ between trainees and non-trainees.

The median depersonalisation score was 4(2–8). Those with high depersonalisation (n=135, 20%) had higher MDS-R scores 90(64–126) versus 63(39–88). The median meaning in work score was 24(21–28.5), and those in the lowest tertile had higher MDS-R scores 74(48–101) versus 64(39–92).

Back to Top | Article Outline


In this national survey of PICU practitioners, moral distress differed based on profession, sex, and those working full-time versus not.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies