Constructing a theoretical model of moral distress

Moral distress has been characterised as one of the main ethical problems affecting nurses in all health systems, and has been depicted as a threat to nurses' integrity and to the quality of patient care. In recent years, several studies tried to investigate moral distress, its causes and consequences for health professionals, clients and organisations. However, such studies are considered controversial and vulnerable, mainly because they lack a solid philosophical and empirical basis. The present article aimed at elaborating a theoretical model for moral distress, taking into consideration the process of moral deliberation, spaces of power and resistance, and patient advocacy, and sought to carry out a reflection that culminated with the creation of a broader concept of moral distress.