Department of Pediatrics, John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada.
Division of Critical Care, and the Faculty of Nursing, John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada.
Chest. 2021 Apr;159(4):1484-1492. doi: 10.1016/j.chest.2020.11.012. Epub 2020 Nov 18.
Worldwide, health-care professionals are experiencing unprecedented stress related to the coronavirus disease 2019 pandemic. Responding to a new virus for which there is no effective treatment yet and no vaccine is beyond challenging. Moral distress, which is experienced when clinicians are unable to act in the way that they believe they should, is often experienced when they are dealing with end-of-life care issues and insufficient resources. Both factors have been widespread during this pandemic, particularly when patients are dying alone and there is a lack of personal protection equipment that plagues many overburdened health-care systems. We explore here, guided by evidence, the concept and features of moral distress and individual resilience. Mitigation strategies involve individual and institutional responsibilities; the importance of solidarity, peer support, psychological first aid, and gratitude are highlighted.
全球范围内，医疗保健专业人员正面临着与 2019 年冠状病毒病大流行相关的前所未有的压力。应对一种尚无有效治疗方法和疫苗的新型病毒极具挑战性。当临床医生无法按照他们认为应该的方式行事时，他们常常会感到道德困境，而这种情况在处理临终关怀问题和资源不足时经常发生。在这场大流行中，这两个因素都非常普遍，尤其是当患者独自死亡且许多不堪重负的医疗保健系统都缺乏个人防护设备时。在这里，我们根据证据探讨了道德困境和个人韧性的概念和特征。缓解策略涉及个人和机构责任；强调了团结、同行支持、心理急救和感恩的重要性。
