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Elizabeth G. Epstein [10]Elizabeth Gingell Epstein [2]
  1.  57
    Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.Elizabeth G. Epstein, Phyllis B. Whitehead, Chuleeporn Prompahakul, Leroy R. Thacker & Ann B. Hamric - 2019 - AJOB Empirical Bioethics 10 (2):113-124.
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  2. Moral Distress, Moral Residue, and the Crescendo Effect.Elizabeth Gingell Epstein & Ann Baile Hamric - 2009 - Journal of Clinical Ethics 20 (4):330-342.
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  3.  24
    A Health System-wide Moral Distress Consultation Service: Development and Evaluation.Ann B. Hamric & Elizabeth G. Epstein - 2017 - HEC Forum 29 (2):127-143.
    Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...)
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  4.  11
    Effect of a Moral Distress Consultation Service on Moral Distress, Empowerment, and a Healthy Work Environment.Elizabeth G. Epstein, Ruhee Shah & Mary Faith Marshall - 2021 - HEC Forum 35 (1):21-35.
    Background: Healthcare providers who are accountable for patient care safety and quality but who are not empowered to actualize them experience moral distress. Interventions to mitigate moral distress in the healthcare organization are needed. Objective: To evaluate the effect on moral distress and clinician empowerment of an established, health-system-wide intervention, Moral Distress Consultation. Methods: A quasi-experimental, mixed methods study using pre/post surveys, structured interviews, and evaluation of consult themes was used. Consults were requested by staff when moral distress was present. (...)
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  5.  28
    Is Broader Better?Elizabeth G. Epstein, Ashley R. Hurst, Dea Mahanes, Mary Faith Marshall & Ann B. Hamric - 2016 - American Journal of Bioethics 16 (12):15-17.
    In their article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) correctly assert that moral distress is well established in the nursing literature and is gaining at...
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  6.  10
    Moral distress among nurses: A mixed-methods study.Chuleeporn Prompahakul, Jessica Keim-Malpass, Virginia LeBaron, Guofen Yan & Elizabeth G. Epstein - 2021 - Nursing Ethics 28 (7-8):1165-1182.
    Background:Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand.Objective:This study aims to describe the experience of moral distress and related factors among Thai nurses.Design:A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of Moral Distress for Healthcare Professionals (...)
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  7.  7
    Moral distress experienced by non-Western nurses: An integrative review.Chuleeporn Prompahakul & Elizabeth G. Epstein - 2020 - Nursing Ethics 27 (3):778-795.
    Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced by non-Western nurses. Review method: (...)
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  8.  8
    Looking at the Positive Side of Moral Distress: Why It’s a Problem.Ashley R. Hurst & Elizabeth G. Epstein - 2017 - Journal of Clinical Ethics 28 (1):37-41.
    Moral distress, is, at its core, an organizational problem. It is experienced on a personal level, but its causes originate within the system itself. In this commentary, we argue that moral distress is not inherently good, that effective interventions must address the external sources of moral distress, and that while there is a place for resilience in the healthcare professions, it cannot be an effective antidote to moral distress.
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  9.  23
    Moral Hazard and Moral Distress: A Marriage Made in Purgatory.Mary Faith Marshall & Elizabeth G. Epstein - 2016 - American Journal of Bioethics 16 (7):46-48.
  10.  49
    Moral obligations of nurses and physicians in neonatal end-of-life care.Elizabeth Gingell Epstein - 2010 - Nursing Ethics 17 (5):577-589.
    The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. Obligations in decision making included talking to parents and timing withdrawal. End-of-life obligations included providing options, preparing (...)
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  11.  11
    Moral distress among nurse leaders: A qualitative systematic review.Preston H. Miller, Elizabeth G. Epstein, Todd B. Smith, Teresa D. Welch, Miranda Smith & Jennifer R. Bail - 2023 - Nursing Ethics 30 (7-8):939-959.
    Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...)
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  12.  15
    Measure for Measure: Condemning the Actor and Not the Fault.Elizabeth G. Epstein, Ashley R. Hurst, Dawn Bourne & Mary Faith Marshall - 2023 - American Journal of Bioethics 23 (4):66-68.
    Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...
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