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  1. From moral distress to burnout through work-family conflict: the protective role of resilience and positive refocusing.Chiara Bernuzzi, Ilaria Setti, Marina Maffoni & Valentina Sommovigo - 2022 - Ethics and Behavior 32 (7):578-600.
    This study analyses for the first time whether and when moral distress may be related to work-family conflict and burnout. Additionally, this study examines whether resilience and positive refocusing might protect healthcare professionals from the negative effects of moral distress. A total of 153 Italian healthcare professionals completed self-report questionnaires. Simple and moderated mediation models revealed that moral distress was positively related to burnout, directly and indirectly, as mediated by work-family conflict. Highly resilient professionals experienced low work-family conflict, regardless of (...)
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  • Moral distress among critical care nurses before and during the COVID-19 pandemic: A systematic review.Fatemeh Beheshtaeen, Camellia Torabizadeh, Sahar Khaki, Narjes Abshorshori & Fatemeh Vizeshfar - forthcoming - Nursing Ethics.
    Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding care provided to critically ill patients in critical care units. The ongoing COVID-19 pandemic has introduced new ethical challenges and changes in clinical practice, further exacerbating the experience of moral distress among these nurses. This systematic review compares the factors influencing moral distress among critical care nurses before and during the COVID-19 pandemic to gain a comprehensive understanding of the impact of (...)
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  • Estimation of moral distress among nurses: A systematic review and meta-analysis.Zainab Alimoradi, Elahe Jafari, Chung-Ying Lin, Raheleh Rajabi, Zohreh Hosseini Marznaki, Mostafa Soodmand, Marc N. Potenza & Amir H. Pakpour - 2023 - Nursing Ethics 30 (3):334-357.
    Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. (...)
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  • Ethical challenges during the COVID-19 pandemic: Perspectives of nursing students.Domingo Palacios-Ceña, Juan Francisco Velarde-García, Marta Mas Espejo, Raquel González-Hervías, Beatriz Álvarez-Embarba, Marta Rodríguez-García, Oscar Oliva-Fernández, Pilar González-Sanz, Paloma Moro-López-Menchero, César Fernández-de-las-Peñas & Jose Miguel Cachón-Pérez - 2022 - Nursing Ethics 29 (2):264-279.
    Background:The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students.Objectives:To explore the ethical dilemmas and ethical conflicts experienced by final-year nursing students who worked during the first outbreak of the COVID-19 pandemic in Spain.Research design:A qualitative exploratory study was conducted using purposive sampling. Semi-structured interviews were carried out using a question guide. Interviews took place via a private video chat room platform. A thematic, inductive (...)
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  • The duty to care and nurses’ well-being during a pandemic.C. Amparo Muñoz-Rubilar, Carolina Pezoa Carrillos, Ingunn Pernille Mundal, Carlos De las Cuevas & Mariela Loreto Lara-Cabrera - 2022 - Nursing Ethics 29 (3):527-539.
    Background: The coronavirus disease 2019 pandemic is impacting the delivery of healthcare worldwide, creating dilemmas related to the duty to care. Although understanding the ethical dilemmas about the duty to care among nurses is necessary to allow effective preparation, few studies have explored these concerns. Aim: This study aimed to identify the ethical dilemmas among clinical nurses in Spain and Chile. It primarily aimed to identify nurses’ agreement with the duty to care despite high risks for themselves and/or their families, (...)
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  • Workplace challenges and nurses recovered from COVID-19.Farshad Mohammadi, Moloud Radfar & Masumeh Hemmati Maslak Pak - 2022 - Nursing Ethics 29 (2):280-292.
    Background: Although many studies have addressed COVID-19, the challenges faced by nurses in their workplace after recovering from this disease have not been investigated. As the backbone of the health system and at the forefront of the fight against COVID-19, nurses are exposed to serious risks of infection and even death. They may also face numerous challenges in their workplace after recovering from COVID-19. It is therefore ethically recommended that the problems of these nurses be solved to increase their job (...)
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  • Ethical challenges during critical phases of the COVID-19 pandemic: An interpretive synthesis.Ignacio Macpherson, María V. Roqué, Luis Echarte & Ignacio Segarra - forthcoming - Nursing Ethics.
    Background During the most critical phases of COVID-19 pandemic, dramatic situations were experienced in hospitals and care centers that nurses could hardly verbalize. Especially relevant were deep challenges related to terminal illness, situations of extreme sacrifice, as well as reflections on protective measures mixed with beliefs. We intend to analyze which problems had the greatest impact on professionals. Aim The aim is to explore the ultimate basis for action when making decisions and the orientation of their behavior in the face (...)
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  • Older patients’ perspectives on illness and healthcare during the early phase of the COVID-19 pandemic.Nina Jøranson, Anne Kari Tolo Heggestad, Hilde Lausund, Grete Breievne, Vigdis Bruun-Olsen, Kristi Elisabeth Heiberg, Marius Myrstad & Anette Hylen Ranhoff - 2022 - Nursing Ethics 29 (4):872-884.
    Background Equal access to healthcare is a core principle in Norway’s public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase – in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic Aim To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation. Research (...)
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  • Digital ethical reflection in long-term care: Leaders’ expectations.Lena Jakobsen, Rose Mari Olsen, Berit Støre Brinchmann & Siri Andreassen Devik - forthcoming - Nursing Ethics.
    Background Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals’ handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools. Research aim This study aimed to explore healthcare leaders’ expectations of using a digital tool for ethical reflection among their home nursing care staff. Research design A qualitative research design with vignettes and focus group interviews (...)
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  • The relationship between emotional labor level and moral distress.Mahinur Durmus Iskender, Handan Eren, Nurcan Çalışkan & Elmas Yılmaz - 2023 - Nursing Ethics 30 (4):500-512.
    BackgroundThe coronavirus disease (COVID-19) pandemic has implications for health professionals.AimThe aim of this study was to explain the relationship between emotional labor levels and moral dis...
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  • Spanish psychometric properties of the moral distress scale—revised: a study in healthcare professionals treating COVID-19 patients.L. Galiana, C. Moreno-Mulet, A. Carrero-Planells, C. López-Deflory, P. García-Pazo, M. Nadal-Servera & N. Sansó - 2023 - BMC Medical Ethics 24 (1):1-12.
    Background Moral distress appears when a healthcare professional is not able to carry out actions in accordance with their professional ethical standards. The Moral Distress Scale-Revised is the most widely used to assess levels of moral distress, but it is not validated in Spanish. The aim of the study is to validate the Spanish version of the Moral Distress Scale – utilised within a sample of Spanish healthcare professionals treating COVID–19 patients. Methods The original (english) and the portuguese and french (...)
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