AimsTo elucidate the meaning of moral distress in nurses caring for critically ill neonates.DesignQualitative study using Husserl's descriptive phenomenology.MethodsBetween April and December 2022, unstructured interviews were conducted with 11 nurses with at least 3 years of neonatal intensive care unit experience in Japan. They were asked to recall experiences of moral distress and to speak freely about their thoughts and feelings at the time. The analysis followed Colaizzi's seven‐step method.ResultsThree themes (‘organisational constraints’, ‘regret’ and ‘unshared experiences’) and seven subtheme clusters were extracted from the nurses' narratives of moral distress, which was the basis of trauma. Subtheme clusters included ‘wavering beliefs’, ‘guilt associated with the death of a child’, ‘powerlessness at being unable to help one's family’ and ‘mismatch with the perceptions and feelings of the family’.ConclusionNurses experience various morally distressing events, but these are processed only as personal problems and give rise to feelings of self‐negation. Therefore, trauma can develop as a result of experiences related to decision‐making and the child's best interests. There is a need to improve nurses' moral resilience and ensure their psychological safety to alleviate moral distress.Implications for the ProfessionThis study clarifies nurses' roles within the neonatal intensive care unit, potentially helping them to handle life‐and‐death issues and cope with feelings of moral distress.ImpactThis study elucidated the meanings of powerlessness underlying the moral distress experienced by neonatal intensive care unit nurses. These results will contribute to releasing suppressed feelings and thoughts and alleviating unavoidable moral distress in this setting.Reporting MethodThis study was performed in accordance with the COREQ guidelines.Patient or Public ContributionNurses with experience in neonatal intensive care unit nursing participated as interviewees. They also verified the credibility of survey results and ensured analytical rigour.

中文翻译：

---

护理危重新生儿的护士在新生儿重症监护病房中经历的道德困扰：一项现象学研究


目的阐明护理危重新生儿的护士道德困扰的含义。设计使用胡塞尔描述性现象学的定性研究。方法在 2022 年 4 月至 12 月期间，对 11 名在日本具有至少 3 年新生儿重症监护病房经验的护士进行了非结构化访谈。他们被要求回忆道德困境的经历，并自由地谈论他们当时的想法和感受。分析遵循 Colaizzi 的七步法。结果从护士对道德困扰的叙述中提取了 3 个主题 （“组织约束”、“遗憾” 和 “未分享的经历”） 和 7 个子主题集群，这是创伤的基础。子主题集群包括 “信念动摇”、“与孩子死亡相关的内疚感”、“无法帮助家人的无能为力 ”和 “与家庭的看法和感受不匹配”。结论护士经历各种道德上令人痛苦的事件，但这些事件仅作为个人问题处理，并引起自我否定的感觉。因此，创伤可能是与决策和儿童最大利益相关的经历的结果。有必要提高护士的道德韧性并确保他们的心理安全，以减轻道德困扰。对职业的影响本研究阐明了护士在新生儿重症监护病房中的角色，可能帮助他们处理生死攸关的问题并应对道德困境。影响本研究阐明了新生儿重症监护病房护士所经历的道德困境背后的无力感含义。这些结果将有助于释放被压抑的感受和想法，并减轻在这种情况下不可避免的道德困扰。报告方法本研究是根据 COREQ 指南进行的。患者或公众贡献具有新生儿重症监护病房护理经验的护士作为受访者参与。他们还验证了调查结果的可信度，并确保了分析的严谨性。