Professional Quality of Life, Moral Distress, and Turnover Intent of Healthcare Providers Working within the Context of Medical Assistance in Dying

Abstract

Background: Despite a longstanding debate regarding personal choice towards death and dying, MAiD was legalized in Canada on June 17th, 2016. Since its integration into the healthcare system, there has been a dearth of literature surrounding providers’ experience with the procedure. Healthcare providers are uniquely positioned within the context of the MAiD experience.

Aim: To explore the experiences of health care providers (nurses and physicians) caring for patients undergoing MAiD as well as to explore the relationships between the concepts, Moral Distress (MD), Professional Quality of Life (Burnout (BU), Secondary Traumatic Stress (STS) and Compassion Satisfaction (CS)), and Intent to Turnover (TO).

Design: This explorative and descriptive cross-sectional study consisted of a self-reported survey that uses both scale items and open-ended questions.

Setting/ Participants: The target population included all nurses and physicians who were active members of a targeted Regional MAiD Network practicing within a designated geographical location within Canada.

Results: N=38 Questionnaires completed. The averages of our measured constructs include Moral Distress (Composite) x= 2.9 (SD 2.03), Moral Distress (Frequency): x= 1,18 (SD .102), Moral Distress (Intensity): x= 1.61 (SD .28) Burnout: x= 2.08 (SD 0.5), Secondary Traumatic Stress x= 2.22 (SD 0.48), Compassion Satisfaction x= 4.18 (SD 0.43) and Turnover Intent: x= 2.22 (SD 0.77). Significant positive correlations were found between inter-scale constructs of Moral Distress (Composite, Frequency, and Intensity), Moral Distress, Burnout, and Secondary Traumatic Stress, and between Burnout and Turnover Intent. Significant negative correlations were also found between Professional Quality of life Inter-Scale constructs of Compassion Satisfaction and Burnout as well as between Compassion Satisfaction and Turnover Intent.

Conclusion: MAiD providers in our study expressed feelings of their work being “rewarding” and “deeply satisfying”, further reflective in their below-average rates of Moral Distress, Burnout, Secondary Traumatic Stress, Turnover Intent, and higher-than-average rates of Compassion Satisfaction. Although the procedure remains controversial, these participants expressed enjoying their work. These reported positive aspects of their roles persisted despite the challenges the COVID-19 pandemic presented.