BC Women's Hospital and Health Centre, 4500 Oak St., Vancouver, BC V6H 3N1, Canada.
Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada.
Int J Environ Res Public Health. 2022 Aug 6;19(15):9701. doi: 10.3390/ijerph19159701.
Pandemic-management plans shift the care model from patient-centred to public-centred and increase the risk of healthcare workers (HCWs) experiencing moral distress (MD). This study aimed to understand HCWs' MD experiences during the COVID-19 pandemic and to identify HCWs' preferred coping strategies. Based on a qualitative research methodology, three surveys were distributed at different stages of the pandemic response in British Columbia (BC), Canada. The thematic analysis of the data revealed common MD themes: concerns about ability to serve patients and about the risks intrinsic to the pandemic. Additionally, it revealed that COVID-19 fatigue and collateral impact of COVID-19 were important ethical challenges faced by the HCWs who completed the surveys. These experiences caused stress, anxiety, increased/decreased empathy, sleep disturbances, and feelings of helplessness. Respondents identified self-care and support provided by colleagues, family members, or friends as their main MD coping mechanisms. To a lesser extent, they also used formal sources of support provided by their employer and identified additional strategies they would like their employers to implement (e.g., improved access to mental health and wellness resources). These results may help inform pandemic policies for the future.
大流行管理计划将护理模式从以患者为中心转变为以公众为中心，并增加医疗保健工作者（HCWs）经历道德困境（MD）的风险。本研究旨在了解 COVID-19 大流行期间 HCWs 的 MD 体验，并确定 HCWs 首选的应对策略。基于定性研究方法，在加拿大不列颠哥伦比亚省（BC）的大流行应对的不同阶段分发了三份调查。数据分析揭示了常见的 MD 主题：对为患者提供服务的能力的担忧，以及对大流行内在风险的担忧。此外，它还揭示了 COVID-19 疲劳和 COVID-19 的附带影响是完成调查的 HCWs 面临的重要伦理挑战。这些经历导致压力、焦虑、同理心增加/减少、睡眠障碍和无助感。受访者将自我保健和同事、家人或朋友提供的支持确定为他们的主要 MD 应对机制。在较小程度上，他们还利用了雇主提供的正式支持来源，并确定了他们希望雇主实施的其他策略（例如，改善获得心理健康和健康资源的机会）。这些结果可能有助于为未来的大流行政策提供信息。
