Moral Distress (MD) is a form of distress that occurs when what we consider ethically correct to do is prevented by a perceived obligation. In the healthcare contexts, experiencing MD can be a source of great mental pain and fatigue for workers. During the COVID-19 pandemic, healthcare workers in Italian hospitals were exposed to numerous possible sources of MD. Investigating its intensity, forms and possible impact on other aspects of work and personal life can be very useful to outline the frame and provide the basis to envision a possible positive resolution. We analyzed 260 questionnaires filled in by medical and nursing staff directly involved in the treatment and care processes of patients with symptoms of SARS-CoV-2 infection, most of them in Lombardy. As hypothesized and in line with the literature, we confirmed a significant correlation between MD and general health status. The MD has also been shown to be a predictor of poorer mental health among healthcare workers. We could not verify any significant correlation with the hospital ethical climate. Demonstrating the impact of the MD on the well-being of healthcare workers is crucial to properly value the ethical aspects of their job. Sometimes these moral aspects are neglected in favor of other parameters. This could help to implement compensatory and preventive measures in case of any future similar situations. Keywords: moral distress, COVID-19, ethics in medicine, mental health of healthcare workers.
Il Moral Distress (MD) è una forma di distress che si verifica quando ciò che si considera eticamente corretto fare, ci è impedito da un obbligo percepito. In ambito sanitario sperimentare MD può essere fonte di grande sofferenza e fatica per il personale. Durante la pandemia da COVID-19 il personale sanitario degli ospedali italiani è stato esposto a numerose possibili fonti di MD. Indagarne intensità, forme e possibile impatto su altri aspetti di lavoro e vita personale può essere molto utile per delineare i contorni e fornire le basi per prospettare una possibile risoluzione positiva. Abbiamo analizzato 260 questionari compilati da personale medico e infermieristico direttamente coinvolto nei processi di cura e di assistenza di pazienti con sintomi di infezione da SARS-CoV-2, quasi tutti in Lombardia. Come ipotizzato e in linea con la letteratura, abbiamo confermato una correlazione significativa fra il MD lo stato di salute generale. Il MD si è dimostrato anche predittore di un peggior stato di salute mentale del personale sanitario. Non abbiamo potuto verificare alcuna correlazione significativa col clima etico ospedaliero. Dimostrare l’impatto del MD sul benessere del personale sanitario è di cruciale importanza per dare il giusto valore agli aspetti etici del lavoro, talvolta trascurati in favore di altri parametri, e poter mettere in atto misure compensative e preventive in caso di situazioni simili in futuro. Parole chiave: moral distress; COVID-19; etica in medicina; salute mentale del personale sanitario.
Il moral distress del personale sanitario in Italia durante l'emergenza dovuta alla pandemia da COVID-19
MARTELLI, SARA
2020/2021
Abstract
Moral Distress (MD) is a form of distress that occurs when what we consider ethically correct to do is prevented by a perceived obligation. In the healthcare contexts, experiencing MD can be a source of great mental pain and fatigue for workers. During the COVID-19 pandemic, healthcare workers in Italian hospitals were exposed to numerous possible sources of MD. Investigating its intensity, forms and possible impact on other aspects of work and personal life can be very useful to outline the frame and provide the basis to envision a possible positive resolution. We analyzed 260 questionnaires filled in by medical and nursing staff directly involved in the treatment and care processes of patients with symptoms of SARS-CoV-2 infection, most of them in Lombardy. As hypothesized and in line with the literature, we confirmed a significant correlation between MD and general health status. The MD has also been shown to be a predictor of poorer mental health among healthcare workers. We could not verify any significant correlation with the hospital ethical climate. Demonstrating the impact of the MD on the well-being of healthcare workers is crucial to properly value the ethical aspects of their job. Sometimes these moral aspects are neglected in favor of other parameters. This could help to implement compensatory and preventive measures in case of any future similar situations. Keywords: moral distress, COVID-19, ethics in medicine, mental health of healthcare workers.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/1075