Petrișor Cristina, Breazu Caius, Doroftei Mădălina, Mărieș Ioana, Popescu Codruța
Anesthesia and Intensive Care II Department, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania.
Anesthesia and Intensive Care 1 Department, The Clinical Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania.
Healthcare (Basel). 2021 Oct 15;9(10):1377. doi: 10.3390/healthcare9101377.
Wide geographical variations in depression and anxiety rates related to the ethical climate have been reported during the COVID-19 pandemic in intensive care units (ICUs). The objective was to investigate whether moral distress is associated and has predictive values for depression, anxiety, and intention to resign.
79 consenting ICU nurses completed MMD-HP and PHQ-4 scales in this cross-sectional study between October 2020-February 2021, after ethical approval. The association between MMD-HP and PHQ-4, and the predictive value of MMD-HP for anxiety, depression, and an intention to leave were analyzed (linear regression and receiver operating characteristics curve analysis).
From MMD-HP items, system related factors had highest scores (Kruskal-Wallis test, < 0.0001). MMD-HP and PHQ-4 were weakly correlated (r = 0.41 [0.21-0.58]). MMD-HP and its system-related factors discriminate between nurses with and without depression or anxiety, while system-related factors differentiate those intending to resign ( < 0.05). The MMD-HP score had 50 [37.54-62.46] sensitivity with 80.95 [60-92.33] specificity to predict the intention to leave, and 76.12 [64.67-84.73] sensitivity with 58.33 [31.95-80.67] specificity to detect anxiety or depression symptoms.
During the COVID-19 pandemic, system-associated factors seem to be the most important root factors inducing moral distress. Moral distress is associated with negative psychological outcomes.
在新冠疫情期间，重症监护病房（ICU）中与道德氛围相关的抑郁和焦虑发生率存在广泛的地域差异。目的是调查道德困扰是否与抑郁、焦虑及辞职意愿相关并具有预测价值。
在2020年10月至2021年2月的这项横断面研究中，79名同意参与的ICU护士在获得伦理批准后完成了MMD-HP和PHQ-4量表。分析了MMD-HP与PHQ-4之间的关联，以及MMD-HP对焦虑、抑郁和离职意愿的预测价值（线性回归和受试者工作特征曲线分析）。
从MMD-HP项目来看，系统相关因素得分最高（Kruskal-Wallis检验，<0.0001）。MMD-HP与PHQ-4呈弱相关（r = 0.41 [0.21 - 0.58]）。MMD-HP及其系统相关因素可区分有抑郁或焦虑与无抑郁或焦虑的护士，而系统相关因素可区分有辞职意愿的护士（<0.05）。MMD-HP评分预测离职意愿时的敏感度为50 [37.54 - 62.46]，特异度为80.95 [60 - 92.33]；检测焦虑或抑郁症状时的敏感度为76.12 [64.67 - 84.73]，特异度为58.33 [31.95 - 80.67]。
在新冠疫情期间，系统相关因素似乎是引发道德困扰的最重要根源因素。道德困扰与负面心理结果相关。
