CONCEPT ANALYSIS ON MORAL SUFFERING

Abstract

Moral suffering is a complex and underexplored phenomenon experienced by healthcare professionals, particularly nurses, when they are unable to act according to their moral judgment due to institutional, hierarchical, or situational constraints. This concept analysis, guided by Walker and Avant’s methodology, aimed to clarify the meaning, attributes, antecedents, and consequences of moral suffering within nursing practice. Literature review revealed that moral suffering is characterized by negative feelings such as frustration, guilt, and helplessness, often accompanied by powerlessness, conflicting loyalties, and uncertainty. Antecedents include moral sensitivity, recognition of ethical dilemmas, and the presence of institutional barriers, while consequences extend to physical and psychological distress, reduced job satisfaction, and compromised patient care. Through model and contrary cases, the analysis illustrates how moral suffering emerges in clinical settings, particularly in contexts of futile medical interventions, end-of-life decisions, and hierarchical conflicts. Empirical referents such as adapted moral distress scales provide measurable insight into the phenomenon. Findings underscore the significance of recognizing and addressing moral suffering to safeguard nurse well-being, enhance patient advocacy, and improve organizational outcomes. This analysis contributes to theory development and highlights the urgent need for interventions and supportive strategies to reduce moral suffering in nursing practice.