<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1657-5997</journal-id>
<journal-title><![CDATA[Aquichan]]></journal-title>
<abbrev-journal-title><![CDATA[Aquichan]]></abbrev-journal-title>
<issn>1657-5997</issn>
<publisher>
<publisher-name><![CDATA[Universidad de La Sabana]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1657-59972019000100011</article-id>
<article-id pub-id-type="doi">10.5294/aqui.2019.19.1.3</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review]]></article-title>
<article-title xml:lang="es"><![CDATA[Angustia moral, señal de problemas éticos en la práctica de enfermería oncológica: revisión de literatura]]></article-title>
<article-title xml:lang="pt"><![CDATA[Angústia moral, sinal de problemas éticos na prática de enfermagem oncológica: revisão de literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas Celis]]></surname>
<given-names><![CDATA[Ivonne]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Concha Méndez]]></surname>
<given-names><![CDATA[Camila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Pontificia Universidad Católica de Chile Escuela de Enfermería ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Calvo Mackenna Unidad de Oncología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Chile</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>19</volume>
<numero>1</numero>
<fpage>11</fpage>
<lpage>15</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S1657-59972019000100011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S1657-59972019000100011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S1657-59972019000100011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective:  To describe the factors that influence the emergence of moral distress in oncology nurses.  Methodology:  integrative review of the literature whose search will be performed in Web of Science databases, CINAHL (EBSCO), Scielo, Proquest, Pubmed and PsycInfo using the keywords moral distress and oncology nursing and their similes in Spanish, without restriction for years of publication until 2017.  Results:  The results of this review were grouped into three groups of factors each with subgroups: 1) Organizational factors: ethical climate, evasive culture and resources for ethics delivered by the organization. 2) Particular clinical situations: pain management, information delivery, futile treatment, and assistance to the patient and their family in the process of death, 3) Interpersonal relationships: poor communication, power relations, trust in the team&#8217;s competence.  Conclusion:  the three factors described are triggers of moral distress in oncology nurses. When there are ethical problems and the nurses do not participate in the deliberation process, these problems can be hidden and be normalized, which can diminish the moral sensitivity of the professionals, as well as the possibility of acting as moral agents.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo:  describir los factores que influyen en el surgimiento de la angustia moral en enfermeras oncológicas.  Metodología:  revisión integradora de la literatura cuya búsqueda se realizó en las bases de datos Web of Science, CINAHL (EBSCO), Scielo, Proquest, Pubmed y PsycInfo, a partir del uso de las palabras clave moral distress y oncology nursing y sus símiles en español, sin restricción por años de publicación hasta 2017.  Resultados:  se clasificaron en tres grupos de factores, cada uno con subgrupos: 1) factores organizacionales: clima ético, cultura evasiva y los recursos para la ética que entrega la organización; 2) situaciones clínicas complejas: el manejo del dolor, la entrega de información, el tratamiento fútil, y la asistencia al paciente y su familia durante el proceso de muerte; 3) relaciones interpersonales: una comunicación deficiente, las relaciones de poder, la confianza en la competencia del equipo.  Conclusión:  los tres factores son desencadenantes de angustia moral en las enfermeras oncológicas. Cuando existen problemas éticos, y las enfermeras no participan del proceso de deliberación, estos pueden quedar ocultos y, así, disminuir la sensibilidad moral de los profesionales, así como la posibilidad de actuar como agentes morales. Es necesario explorar la relación entre la angustia moral y las implicancias en el cuidado del paciente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Objetivo:  descrever os fatores que influenciam no surgimento da angústia moral em enfermeiras oncológicas.  Metodologia:  revisão integradora da literatura cuja pesquisa foi realizada nas bases de dados Web of Science, CINAHL (EBSCO), Scielo, Proquest, Pubmed e PsycInfo, a partir do uso das palavras-chave moral, distress e oncology nursing e seus pares em espanhol, sem restrição por ano de publicação até 2017.  Resultados:  criou-se três grupos de fatores, cada um deles com subgrupos: 1) fatores organizacionais - clima ético, cultura evasiva e recursos para a ética que a organização entrega; 2) situações clínicas complexas - o tratamento da dor, a entrega de informação, o tratamento fútil e a assistência ao paciente e à sua família durante o processo de morte; 3) relações interpessoais - uma comunicação deficiente, as relações de poder, a confiança na competência da equipe.  Conclusão:  os três fatores são desencadeantes de angústia moral nas enfermeiras oncológicas. Quando existem problemas éticos e as enfermeiras não participam do processo de deliberação, estes podem ficam ocultos e, assim, diminuir a sensibilidade moral dos profissionais, bem como a possibilidade de atuar como agentes morais. É necessário explorar a relação entre a angústia moral e suas implicações no cuidado do paciente.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Moral distress]]></kwd>
<kwd lng="en"><![CDATA[oncology nursing]]></kwd>
<kwd lng="en"><![CDATA[ethics]]></kwd>
<kwd lng="en"><![CDATA[ethical climate]]></kwd>
<kwd lng="en"><![CDATA[ethical issues]]></kwd>
<kwd lng="en"><![CDATA[interprofessional relations]]></kwd>
<kwd lng="es"><![CDATA[Angustia moral]]></kwd>
<kwd lng="es"><![CDATA[enfermería oncológica]]></kwd>
<kwd lng="es"><![CDATA[clima ético]]></kwd>
<kwd lng="es"><![CDATA[problemas éticos]]></kwd>
<kwd lng="es"><![CDATA[relaciones interprofesionales]]></kwd>
<kwd lng="pt"><![CDATA[DeCS): Angústia moral]]></kwd>
<kwd lng="pt"><![CDATA[enfermagem]]></kwd>
<kwd lng="pt"><![CDATA[oncología]]></kwd>
<kwd lng="pt"><![CDATA[clima ético]]></kwd>
<kwd lng="pt"><![CDATA[problemas éticos]]></kwd>
<kwd lng="pt"><![CDATA[sensibilidade moral]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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