Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review

Nagle, Evija; Šuriņa, Sanita; Griškēviča, Ingūna

doi:10.3390/socsci12070371

Cited by 5 publications

References 70 publications

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Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19

Burgess,

Rennie,

Moodley

2024

Research Ethics

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South African research ethics committees (RECs) faced significant challenges during the COVID-19 pandemic. Research ethics committees needed to find a balance between careful consideration of scientific validity and ethical merit of protocols, and review with the urgency normally associated with public health emergency research. We aimed to explore the views of South African RECs on their pandemic preparedness and response during COVID-19. We conducted in-depth interviews with 21 participants from RECs that were actively involved in the review of COVID-19 related research, at seven academic institutions across South Africa. Interviews were conducted remotely using an in-depth interview guide that included questions regarding REC preparedness and response to COVID-19. Interviews were conducted until data saturation, and audio-recordings were transcribed verbatim and coded. An inductive approach to thematic analysis was used to organise data into themes and sub-themes. This study focused on three main themes: coping during COVID-19, building REC capacity during pandemic times and a consistently cautious approach to mutual recognition of REC reviews. Despite an initial sense of unpreparedness, RECs were able to adapt and maintain careful ethical oversight of both COVID and non-COVID research, and the rigour of REC reviews. Several important lessons for preparedness and response to future pandemics were identified, including heightened awareness of publication, funding and political pressures, the importance of regular training for RECs and researchers, and strategies to enhance moral resilience of REC members. Incremental steps are needed to build trust and authentic partnerships among RECs in inter-pandemic times, to facilitate collaboration during future public health emergencies.

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Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19

Burgess,

Rennie,

Moodley

2024

Research Ethics

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Moral distress and protective work environment for healthcare workers during public health emergencies

Bondjers,

Glad,

Wøien

et al. 2024

BMC Med Ethics

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Background Public health emergencies, such as the Covid-19 pandemic, put great pressure on healthcare workers (HCW) across the world, possibly increasing the risk of experiencing ethically challenging situations (ECS). Whereas experiencing ECS as a HCW in such situations is likely unavoidable, mitigation of their adverse effects (e.g., moral distress) is necessary to reduce the risk of long-term negative consequences. One possible route of mitigation of these effects is via work environmental factors. Objectives The current study aimed to examine: [ 1 ] risk factors associated with ECS among HCW [ 2 ], intensity of moral distress associated with ECS across various occupational factors (i.e., profession, degree of exposure to patients with Covid-19), and [ 3 ] the impact of work environmental factors on this association, in a sample of HCW during the pandemic. Methods We employed multiple logistic and linear regression to self-report data from 977 HCWs at four Norwegian hospitals responding to a survey at the fourth wave of the pandemic. Results About half of HCW in this study had experienced ECS during the pandemic, and levels of moral distress associated with such were higher than in previous studies using similar assessment methods. Younger age, female sex, geographical work area (mid-north of Norway), and profession (nurse) were all associated with higher odds (range of OR: 1.30–2.59) of experiencing ECS, as were direct contact with patients with Covid-19. Among those participants who reported that they had experienced ECS during the pandemic, moral distress levels when recalling those situations were moderate (Mean 5.7 on a 0–10 scale). Men reported somewhat lower intensity of moral distress (partial eta squared; ηp 2 = 0.02). Reporting a manageable workload (ηp 2 = 0.02), and greater opportunity to work according to best practice (ηp 2 = 0.02), were associated with lower levels of moral distress. Conclusions Our findings suggest that moral distress could potentially be mitigated on an organizational level, particularly by focusing on ensuring a manageable workload, and an ability to work according to best practice. To build sustainable healthcare systems robust enough to withstand future public health emergencies, healthcare organizations should implement measures to facilitate these aspects of HCWs’ work environment. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-024-01098-w.

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Factors affecting healthcare workers burnout and their conceptual models: scoping review

Nagle,

Griskevica,

Rajevska

et al. 2024

BMC Psychol

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Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review

Cited by 5 publications

References 70 publications

Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19

Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19

Moral distress and protective work environment for healthcare workers during public health emergencies

Factors affecting healthcare workers burnout and their conceptual models: scoping review

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