Ethical Conflict and Its Psychological Correlates Among Hospital Nurses in the Pandemic: A Cross-Sectional Study Within Swiss COVID-19 and Non-COVID-19 Wards

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2021 Nov 27

PMID 34831768

Citations 8

Authors

Michele Villa

Colette Balice-Bourgois

Angela Tolotti

Anna Falco-Pegueroles

Serena Barello

Elena Corina Luca

Luca Clivio

Annette Biegger

Dario Valcarenghi

Loris Bonetti

Affiliations

Soon will be listed here.

Abstract

Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses' ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not.

Methods: Design-Multicentre online survey. Setting-Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman's rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses' characteristics and outcome variables, and the Mann-Whitney/t-test to compare groups.

Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low-moderate level of ethical conflict (median = 111.5 [76-152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress (546) = 0.453, < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96-13.01; < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56-9.6; < 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict.

Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.

Citing Articles

COVID-19 and nurses' ethical issues: Comparisons between two European countries.

Usberg G, Clari M, Conti A, Pold M, Kalda R, Kangasniemi M Nurs Ethics. 2024; 31(8):1674-1687.

PMID: 38835232 PMC: 11577683. DOI: 10.1177/09697330241255936.

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry.

Tolotti A, Liptrott S, Bonetti L, Cavatorti S, Sari D, Caoduro L Healthcare (Basel). 2024; 12(4).

PMID: 38391823 PMC: 10887853. DOI: 10.3390/healthcare12040447.

Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study.

Tolotti A, Bonetti L, Luca C, Villa M, Liptrott S, Steiner L Healthcare (Basel). 2024; 12(1).

PMID: 38201019 PMC: 10778578. DOI: 10.3390/healthcare12010114.

The Effectiveness of Healthcare System Resilience during the COVID-19 Pandemic: A Case Study.

Borzuchowska M, Kilanska D, Kozlowski R, Iltchev P, Czapla T, Marczewska S Medicina (Kaunas). 2023; 59(5).

PMID: 37241178 PMC: 10221935. DOI: 10.3390/medicina59050946.

Moral Distress of Intensive Care Nurses: A Phenomenological Qualitative Study Two Years after the First Wave of the COVID-19 Pandemic.

Rosa D, Bonetti L, Villa G, Allieri S, Baldrighi R, Elisei R Int J Environ Res Public Health. 2022; 19(22).

PMID: 36429775 PMC: 9690457. DOI: 10.3390/ijerph192215057.

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