Moral distress, coping mechanisms, and turnover intent among doctors, nurses, and in-home or community care providers in British Columbia
Bibliographic record
Abstract
Objectives:Moral distress has been identified as both a contributor to healthcare worker attrition as well as an outcome of it. To this aim, our study applies intersectional analysis to explore moral distress levels among doctors, nurses, and in-home- or community-care-providers in British Columbia, Canada with a specific focus on the intersection of race and gender identity. Furthermore, it aims to identify which experiences were more distressing, and the predicted turnover intent for each intersecting identity and profession.Methods:We conducted an online survey of 1,314 healthcare professionals from all health regions of BC. Our descriptive analysis was stratified by the participants’ profession. The categorical variables included age, gender, racial identity, migratory history, and type of work contract. The continuous variables included a moral distress score (range: 0 to 144) and a mitigation score consisting of 11 distress-coping strategies (range: 0 to 275).Results:Nurses had significantly higher moral distress scores compared to physicians and in-home- or community-care-practitioners (H-CCPs). Only 24.7% of physicians had considered leaving their position or had already left, compared to 61.3% of H-CCP, and 72.7% of nurses. White women had significantly higher moral distress levels than White and Indigenous men, whereas women of colour were more distressed than White men, though these differences were no longer significant after adjusting the scores by profession. Men had higher mitigation scores than women across all groups. Sources of distress and mitigation strategies differed across identity groups. White men had a significantly lower turnover intention (15.3%) than all other groups. Conclusion:High distress scores and turnover intention responses, particularly among women and racialized healthcare workers indicate an urgent need to address the root causes of moral distress.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".