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. 2022 Aug 6;19(15):9701.
doi: 10.3390/ijerph19159701.

COVID-19 Outbreak: Understanding Moral-Distress Experiences Faced by Healthcare Workers in British Columbia, Canada

Esther Alonso-Prieto  1   2 , Holly Longstaff  3   4 , Agnes Black  5 , Alice K Virani  3   6
Affiliations

COVID-19 Outbreak: Understanding Moral-Distress Experiences Faced by Healthcare Workers in British Columbia, Canada

Esther Alonso-Prieto et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: COVID-19; ethical dilemmas; moral distress.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
Timeline of surveys superimposed on a graph depicting the waves of COVID-19 cases in BC, Canada as published by BC Centre for Disease Control (https://experience.arcgis.com/experience/a6f23959a8b14bfa989e3cda29297ded, accessed on 20 June 2022). Most relevant public-health measures in effect during each survey period are also summarized [25].
Figure 2
Figure 2
Graphical depiction of the thematic framework showing 3 main themes and 6 sub-themes underlying moral distress experiences of BC HCWs during COVID-19.
Figure 3
Figure 3
Number of responses corresponding to theme 1: HCWs’ capacity to serve patients. Since participants could select multiple themes, it is not possible to calculate percentages.
Figure 4
Figure 4
Number of responses corresponding to theme 2: Risks of COVID-19 infection and transmission. Since participants could select multiple themes, it is not possible to calculate percentages.
Figure 5
Figure 5
Number of responses corresponding to theme 3: Disagreement with COVID-19 protocols. Since participants could select multiple themes, it is not possible to calculate percentages.
Figure 6
Figure 6
Number of responses on the impact of moral distress. Since participants could select multiple themes, it is not possible to calculate percentages.
Figure 7
Figure 7
Sources of support to cope with negative psychological impacts of COVID-19. Since participants could select multiple themes, it is not possible to calculate percentages.
See this image and copyright information in PMC

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