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Moral distress, emotional impact and coping in intensive care unit staff during the outbreak of COVID-19.
Romero-García, Marta; Delgado-Hito, Pilar; Gálvez-Herrer, Macarena; Ángel-Sesmero, José Antonio; Velasco-Sanz, Tamara Raquel; Benito-Aracil, Llucia; Heras-La Calle, Gabriel.
  • Romero-García M; School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain.
  • Delgado-Hito P; School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain.
  • Gálvez-Herrer M; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain; Stress and Health Research Team, Autonomous University of Madrid (Madrid), Spain.
  • Ángel-Sesmero JA; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain; Infanta Leonor University Hospital (Madrid), Spain.
  • Velasco-Sanz TR; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain; Clínico San Carlos University Hospital (Madrid), Spain; Faculty of Nursing, Physiotherapy and Podiatry Complutense University (Madrid) Spain.
  • Benito-Aracil L; School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain. Electronic address: lbenito@ub.edu.
  • Heras-La Calle G; Hospital Comarcal Santa Ana, Motril (Granada), Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain; Universidad Francisco de Vitoria, Madrid, Spain.
Intensive Crit Care Nurs ; 70: 103206, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1878178
ABSTRACT

BACKGROUND:

From the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals' mental health during the pandemic.

OBJECTIVES:

To assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain.

DESIGN:

Cross-sectional. SETTINGS AND

PARTICIPANTS:

The study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020.

METHODS:

Sociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression.

RESULTS:

Moral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression.

CONCLUSIONS:

Our study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychological Distress / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Intensive Crit Care Nurs Journal subject: Nursing / Critical Care Year: 2022 Document Type: Article Affiliation country: J.iccn.2022.103206

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychological Distress / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Intensive Crit Care Nurs Journal subject: Nursing / Critical Care Year: 2022 Document Type: Article Affiliation country: J.iccn.2022.103206