Moral Distress and Moral Injury in Nephrology During the COVID-19 Pandemic.

Across the world, challenges for clinicians providing health care during the coronavirus disease 2019 (COVID-19) pandemic are highly prevalent and have been widely reported. Perspectives of provider groups have conveyed wide-ranging experiences of adversity, distress, and resilience. In understanding and responding to the emotional and psychological implications of the pandemic for renal clinicians, it is vital to recognize that many experiences also have been ethically challenging. The COVID-19 pandemic has prompted rapid and extensive transformation of health care systems and widely impacted care provision, heightening the risk of barriers to fulfillment of ethical duties. Given this, it is likely that some clinicians also have experienced moral distress, which can occur if an individual is unable to act in accordance with their moral judgment owing to external barriers. This review presents a global perspective of potential experiences of moral distress in kidney care during the COVID-19 pandemic. Using nephrology cases, we discuss why moral distress may be experienced by health professionals when withholding or withdrawing potentially beneficial treatments owing to resource constraints, when providing care that is inconsistent with local prepandemic best practice standards, and when managing dual professional and personal roles with conflicting responsibilities. We argue that in addition to responsive and appropriate health system supports, resources, and education, it is imperative for health care providers to recognize and prevent moral distress to foster the psychological well-being and moral resilience of clinicians during extended periods of crisis within health systems.

What can influence a county’s resilience and susceptibility to coronavirus in Nebraska?

This study sought to classify and assign the 93 counties in Nebraska into distinctive spatial-temporal clusters based on their trends in the number of COVID-19 confirmed cases and deaths. A secondary goal of this study was to assess the potential role of preexisting sociodemographic, environmental, and health conditions in determining the county’s resilience and susceptibility to 2019-nCov. Spatial-temporal cluster analysis yielded three distinct confirmed cases and death clusters. Results from spatial-temporal cluster and regression analyses suggested that COVID-19 and HIV and obesity prevention should be integrated. Emergency response planning and mitigation should focus on counties characterized by noticeable increases in the number of COVID-19 confirmed cases and deaths and/or counties with relatively high population and ethnic minorities. [ABSTRACT FROM AUTHOR] Copyright of Sociological Spectrum is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)