Moral Distress Among Family Caregivers: A Concept Analysis

ABSTRACT

Aim

To examine and define the concept of moral distress among family caregivers by identifying its key attributes, antecedents and consequences.

Design

Concept analysis.

Methods

This study was guided by Walker and Avant's concept analysis framework. A comprehensive literature search was conducted to identify relevant studies, with 12 articles included in this analysis.

Data Sources

PubMed, CINAHL, Scopus and PsycINFO databases were searched for articles published between February 2000 and May 2025.

Results

Three defining attributes of moral distress in family caregivers were identified: self-directed negative emotions, internal conflict and feelings of powerlessness and helplessness. Antecedents included caregiving burden, role conflict, ethical dilemmas, complex decision-making and internal and external constraints. Consequences encompassed long-term health effects, social withdrawal, burnout and moral residue. These findings led to a conceptual definition of moral distress in family caregivers.

Conclusion

Moral distress in family caregivers is a significant and underrecognised issue that affects caregiver well-being and the quality of care they provide. This concept analysis offers a clear conceptual definition, providing a foundation for developing research instruments and interventions.

Implications for the Profession and/or Patient Care

Healthcare professionals should recognise moral distress in family caregivers as a key factor impacting both caregiver well-being and patient care. Support through education, counselling and peer groups can reduce moral distress and foster more ethical, collaborative care environments.

Impact

This study addressed the lack of clarity surrounding moral distress in family caregivers. It identified key attributes, antecedents, and consequences, and developed a clear conceptual definition. These insights will inform research, practice and policy. The findings will benefit caregivers, improve patient care and support healthcare teams.

Reporting Method

This study followed Walker and Avant's framework and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in article selection.

Patient or Public Contribution

No patient or public involvement.