Effect of Structural Moral Case Deliberation on Burnout Symptoms, Moral Distress, and Team Climate in ICU Professionals: A Parallel Cluster Randomized Trial*
Authors' conclusion
Although structural MCD did not mitigate emotional exhaustion or depersonalization, and reduced personal accomplishment in ICU professionals, it did reduce moral distress. Moreover, it did not improve team climate, but improved the organizational culture.
Study context
- Population
- ICU professionals in six ICUs in two hospitals in Nijmegen, January 2020–September 2021
- Participants
- 435 professionals · 6 ICUs
- Comparison
- Structural moral case deliberation vs no structural moral case deliberation (MCD)
- Primary endpoint
- Burnout symptoms (emotional exhaustion, depersonalization, low sense of personal accomplishment; Maslach Burnout Inventory, 0-6 scale)
- Follow-up
- Baseline and 6-, 12-, and 21-month follow-ups
Methodological detailsparallel, intention-to-treat
- Parallel
- Intention-to-treat
Primary result
As reported in the abstract
Burnout symptoms (Maslach Burnout Inventory, 0-6 scale)
Personal accomplishment: reduced by structural MCD (p < 0.05)
−0.15
Secondary outcomes
Moral distress (Moral Distress Scale, 0-336 scale)
- Reduced by structural MCD (p < 0.01)
- −5.48
Team climate (Safety Attitude Questionnaire, 0-4 scale)
- Not affected by structural MCD
Organizational culture: perceived organizational support (culture of care barometer, 0-4 scale)
- Improved with structural MCD (p < 0.01)
- 0.15
- Explorative outcome
Organizational culture: leadership
- Improved with structural MCD (p < 0.001)
- 0.19
- Explorative outcome
Organizational culture: participation opportunities
- Improved with structural MCD (p < 0.05)
- 0.13
- Explorative outcome
Original publication
Effect of Structural Moral Case Deliberation on Burnout Symptoms, Moral Distress, and Team Climate in ICU Professionals: A Parallel Cluster Randomized Trial*. Crit Care Med. Published 5 June 2023. doi:10.
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