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

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...

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Autores principales:	Michele Villa, Colette Balice-Bourgois, Angela Tolotti, Anna Falcó-Pegueroles, Serena Barello, Elena Corina Luca, Luca Clivio, Annette Biegger, Dario Valcarenghi, Loris Bonetti
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	ethical conflict nurse resilience psychological distress SARS-Cov-2 Covid-19 Medicine R
Acceso en línea:	https://doaj.org/article/45b8d74497f8485caf21c38bf342e1e1
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spelling	oai:doaj.org-article:45b8d74497f8485caf21c38bf342e1e12021-11-25T17:50:19ZEthical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards10.3390/ijerph1822120121660-46011661-7827https://doaj.org/article/45b8d74497f8485caf21c38bf342e1e12021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/22/12012https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Background: 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 <i>rs</i> (546) = 0.453, <i>p</i> < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; <i>p</i> < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; <i>p</i> < 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.Michele VillaColette Balice-BourgoisAngela TolottiAnna Falcó-PeguerolesSerena BarelloElena Corina LucaLuca ClivioAnnette BieggerDario ValcarenghiLoris BonettiMDPI AGarticleethical conflictnurseresiliencepsychological distressSARS-Cov-2Covid-19MedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 12012, p 12012 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ethical conflict nurse resilience psychological distress SARS-Cov-2 Covid-19 Medicine R
spellingShingle	ethical conflict nurse resilience psychological distress SARS-Cov-2 Covid-19 Medicine R Michele Villa Colette Balice-Bourgois Angela Tolotti Anna Falcó-Pegueroles Serena Barello Elena Corina Luca Luca Clivio Annette Biegger Dario Valcarenghi Loris Bonetti 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
description	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 <i>rs</i> (546) = 0.453, <i>p</i> < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; <i>p</i> < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; <i>p</i> < 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.
format	article
author	Michele Villa Colette Balice-Bourgois Angela Tolotti Anna Falcó-Pegueroles Serena Barello Elena Corina Luca Luca Clivio Annette Biegger Dario Valcarenghi Loris Bonetti
author_facet	Michele Villa Colette Balice-Bourgois Angela Tolotti Anna Falcó-Pegueroles Serena Barello Elena Corina Luca Luca Clivio Annette Biegger Dario Valcarenghi Loris Bonetti
author_sort	Michele Villa
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/45b8d74497f8485caf21c38bf342e1e1
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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

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