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Villa M, Balice-Bourgois C, Tolotti A, Falcó-Pegueroles A, Barello S, Luca EC, Clivio L, Biegger A, Valcarenghi D, Bonetti L. Ethical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212012. [PMID: 34831768 PMCID: PMC8618535 DOI: 10.3390/ijerph182212012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses’ ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not. Methods: Design—Multicentre online survey. Setting—Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman’s rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses’ characteristics and outcome variables, and the Mann–Whitney/t-test to compare groups. Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low–moderate level of ethical conflict (median = 111.5 [76–152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress rs (546) = 0.453, p < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; p < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; p < 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict. Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.
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Affiliation(s)
- Michele Villa
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900 Lugano, Switzerland;
| | - Colette Balice-Bourgois
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Correspondence:
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain), Campus Bellvitge, Pavelló de Govern, 3a planta, Despatx 331, Feixa Llarga, s/n L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy;
| | - Elena Corina Luca
- Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland;
| | - Luca Clivio
- ICT Data Science & Research Unit, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland;
| | - Annette Biegger
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzonal, Switzerland;
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Loris Bonetti
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
- Department of Business Economics, University of Applied Sciences and Arts of Southern Switzerland, Health and Social Care, Via Violino, 11, 6928 Manno, Switzerland
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Thiruvenkatarajan V, Wong DT, Kothandan H, Sekhar V, Adhikary SD, Currie J, Van Wijk R. In Response. Anesth Analg 2021; 132:e43-e44. [PMID: 33591101 DOI: 10.1213/ane.0000000000005338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Venkatesan Thiruvenkatarajan
- Department of Anesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, Australia, Department of Acute Care Medicine, University of Adelaide, Adelaide, South Australia, Australia,
| | - David T Wong
- Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Vimal Sekhar
- Department of Anesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Sanjib Das Adhikary
- Department of Anesthesiology and Perioperative Medicine, Penn State Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - John Currie
- Department of Anesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Roelof Van Wijk
- Department of Anesthesia, The Queen Elizabeth Hospital, Woodville, South Australia, Australia, Department of Acute Care Medicine, University of Adelaide, Adelaide, South Australia, Australia
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