title: Moral distress related to ethical dilemmas among Spanish podiatrists.
abstract: OBJECTIVE
  To describe the distress experienced by Spanish podiatrists related to ethical dilemmas, organisational matters, and lack of resources.
  
  
  METHODS
  A 2008 email survey of a representative sample of 485 Spanish podiatrists presenting statements about different ethical dilemmas, values and goals at the workplace.
  
  
  RESULTS
  The response rate was 44.8%. Of all the respondents, 57% described sometimes having to act against their own conscience as distressing. Time constraints is the main cause of moral distress (67%) and 58% of respondents said that they found it distressing that patients have long waits for treatment. Distress related to inadequate treatment due to economical constraints or ineffectiveness was described by 60% of the podiatrists. Another 51% reported that time spent on administration and documentation is distressing. Female doctors experienced more distress than their male colleagues. Last, 36% of respondents reported that their workplace lacked strategies for dealing with ethical dilemmas.
  
  
  CONCLUSIONS
  These study results identify moral distress among Spanish podiatrists mainly related to time constraints, patient demands and lack of resources. Moral distress varies with sex and age. Organisational strategies such as moral deliberation and responsive evaluation offer the potential to address moral distress.
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain. marta.losa@urjc.es
authors.forename: Marta Elena
authors.initials: ME
authors.lastname: Losa Iglesias
authors.forename: Ricardo
authors.initials: R
authors.lastname: Becerro de Bengoa Vallejo
authors.forename: Paloma
authors.initials: P
authors.lastname: Salvadores Fuentes
mesh_terms: D000328:Adult; D000368:Aged; D026688:Bioethical Issues; D003695:Delivery of Health Care / Q000941:ethics; D004992:Ethics, Medical; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D028681:Moral Obligations; D011032:Podiatry / Q000941:ethics*; D013030:Spain; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D017132:Workplace