Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19

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 dist...

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Autores: Romero García, Marta, Delgado Hito, Pilar, Gálvez Herrer, Macarena, Ángel Sesmero, José Antonio, Velasco Sanz, Tamara Raquel, Benito Aracil, Llucia, Heras La Calle, Gabriel
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/116893
Acceso en línea:https://hdl.handle.net/20.500.14352/116893
Access Level:acceso abierto
Palabra clave:61
Anxiety
Coping
COVID-19
Depression
ICU staff
Moral distress
Nurses
Ciencias Biomédicas
32 Ciencias Médicas
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repository_id_str
spelling Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19Romero García, MartaDelgado Hito, PilarGálvez Herrer, MacarenaÁngel Sesmero, José AntonioVelasco Sanz, Tamara RaquelBenito Aracil, LluciaHeras La Calle, Gabriel61AnxietyCopingCOVID-19DepressionICU staffMoral distressNursesCiencias Biomédicas32 Ciencias MédicasBackground: 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.ElsevierUniversidad Complutense de Madrid20222022-01-2120222022-01-21journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/116893reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1168932026-06-02T12:44:21Z
dc.title.none.fl_str_mv Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
title Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
spellingShingle Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
Romero García, Marta
61
Anxiety
Coping
COVID-19
Depression
ICU staff
Moral distress
Nurses
Ciencias Biomédicas
32 Ciencias Médicas
title_short Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
title_full Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
title_fullStr Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
title_full_unstemmed Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
title_sort Moral distress, emotional impact and coping in intensive care units staff during the outbreak of COVID-19
dc.creator.none.fl_str_mv Romero García, Marta
Delgado Hito, Pilar
Gálvez Herrer, Macarena
Ángel Sesmero, José Antonio
Velasco Sanz, Tamara Raquel
Benito Aracil, Llucia
Heras La Calle, Gabriel
author Romero García, Marta
author_facet Romero García, Marta
Delgado Hito, Pilar
Gálvez Herrer, Macarena
Ángel Sesmero, José Antonio
Velasco Sanz, Tamara Raquel
Benito Aracil, Llucia
Heras La Calle, Gabriel
author_role author
author2 Delgado Hito, Pilar
Gálvez Herrer, Macarena
Ángel Sesmero, José Antonio
Velasco Sanz, Tamara Raquel
Benito Aracil, Llucia
Heras La Calle, Gabriel
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 61
Anxiety
Coping
COVID-19
Depression
ICU staff
Moral distress
Nurses
Ciencias Biomédicas
32 Ciencias Médicas
topic 61
Anxiety
Coping
COVID-19
Depression
ICU staff
Moral distress
Nurses
Ciencias Biomédicas
32 Ciencias Médicas
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-21
2022
2022-01-21
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/116893
url https://hdl.handle.net/20.500.14352/116893
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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