Clark Drew B A, Smith Kristina, Alonso-Prieto Esther, Virani Alice
School of Nursing, Faculty of Applied Science, The University of British Columbia, Vancouver, British Columbia, Canada.
Ethics Services, Vancouver Coastal Health, Vancouver, British Columbia, Canada.
Nurs Inq. 2025 Oct;32(4):e70051. doi: 10.1111/nin.70051.
Moral distress increased among healthcare workers during the first three years of the COVID-19 pandemic. This qualitative descriptive study explored the experiences of thirteen healthcare professionals with expertise in supporting healthcare workers experiencing moral distress within Canadian healthcare systems during this time. Participants reported multiple factors driving moral distress, such as resource scarcity (e.g., staffing shortages), policies (e.g., vaccination), and sociopolitical issues (e.g., diminishing support for healthcare workers). A range of interventions was employed to address moral distress, including: education, debriefing, consultation, mentorship, and general wellness programs. A strong knowledge of moral distress and counselling skills were both cited as necessary tools for individuals facilitating moral distress interventions. Values central to experiences of moral distress (e.g., transparency, accountability, respect, care) were identified, and participants described factors that could support organizational change to align with these values to better address moral distress (e.g., transparent communication, capacity-building). Finally, participants called for societal and political support for resource allocation to healthcare systems to ensure system sustainability and the ability of healthcare professionals to provide ethically sound care to all members of society.
在新冠疫情的头三年里，医护人员的道德困扰有所增加。这项定性描述性研究探讨了13名医疗保健专业人员在此期间的经历，这些专业人员在加拿大医疗系统中为经历道德困扰的医护人员提供支持方面拥有专业知识。参与者报告了导致道德困扰的多种因素，如资源稀缺（如人员短缺）、政策（如疫苗接种）和社会政治问题（如对医护人员的支持减少）。为应对道德困扰采取了一系列干预措施，包括：教育、汇报、咨询、指导和一般健康计划。对道德困扰的深入了解和咨询技巧都被认为是促进道德困扰干预的个人必备工具。确定了道德困扰经历中的核心价值观（如透明度、问责制、尊重、关怀），参与者描述了有助于组织变革以符合这些价值观从而更好地应对道德困扰的因素（如透明沟通、能力建设）。最后，参与者呼吁社会和政治为医疗系统的资源分配提供支持，以确保系统的可持续性以及医护人员为社会所有成员提供符合道德规范护理的能力。
