Moral distress among maternity and neonatal healthcare workers during the COVID-19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-04-18 DOI:10.1111/aogs.15125

Patricia Ernst, Karolina Linden, Marta Roczniewska, Emina Hadzibajramovic, Anna Wessberg, Ola Andersson, Ylva Carlsson, Sofie Graner, Maria Jonsson, Malin Veje, Verena Sengpiel, Magnus Akerstrom

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引用次数: 0

Abstract

Introduction

Moral distress arises when healthcare workers face difficult decisions without adequate information and/or when patient care is compromised due to limited resources, communication issues, or altered work routines in exceptional circumstances. While moral distress in maternity and neonatal healthcare workers (MNHCWs) has been noted, its prevalence, intensity, and impact on well-being and turnover in Sweden remain unexplored. The aim of this study was to investigate the level of disturbance and frequency of experiencing moral distress among Swedish MNHCWs during the COVID-19 pandemic and the effects on MNHCWs' well-being and intention to leave their job.

Material and Methods

A longitudinal cohort study was conducted during January–May 2021 (n = 645) and January–March 2022 (n = 503), utilizing the Moral Distress Scale-Revised (MDS-R). The study was set in hospital-based maternity and neonatal units across all 21 Swedish healthcare regions and included midwives, physicians, registered nurses, and assistant nurses. Quantitative and descriptive analyses were performed, with comparisons of moral distress levels between time points and professions. The main outcome measures were moral distress (level of disturbance and frequency) and intention to leave their job.

Results

Among the respondents, 6%–47% reported being frequently exposed to morally challenging situations, and 51%–91% reported a high level of disturbance in connection to such situations. Uncertain staffing, continuity-of-care challenges, and limited opportunities for patient/family counseling posed frequent moral challenges across time and professions. Of the respondents, 14% in 2021 and 18% in 2022 considered leaving their jobs due to moral distress. There were no overall significant differences in outcomes between the two time points.

Conclusions

Swedish MNHCWs commonly experienced moral distress during the COVID-19 pandemic. Interventions targeting underlying reasons may be needed to ensure the well-being of MNHCWs in situations when the healthcare system is under strained working conditions.

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瑞典COVID-19大流行期间孕产妇和新生儿医护人员的道德困境：来自COPE员工纵向队列研究的结果

简介：当卫生保健工作者在没有充分信息的情况下面临困难的决定和/或当由于资源有限、沟通问题或在特殊情况下改变工作惯例而损害患者护理时，就会出现道德困扰。虽然已经注意到产妇和新生儿保健工作者（MNHCWs）的道德困扰，但其流行程度、强度以及对瑞典福祉和营业额的影响仍未得到探讨。本研究的目的是调查2019冠状病毒病大流行期间瑞典MNHCWs遭受道德困扰的程度和频率，以及对MNHCWs幸福感和离职意向的影响。材料和方法：在2021年1月至5月（n = 645）和2022年1月至3月（n = 503）期间进行了一项纵向队列研究，使用道德困扰量表-修订版（MDS-R）。该研究在瑞典所有21个医疗保健地区的医院产科和新生儿病房进行，包括助产士、医生、注册护士和助理护士。进行了定量和描述性分析，比较了时间点和职业之间的道德困扰水平。主要结果测量是道德困扰（干扰程度和频率）和离职意向。结果：在受访者中，6%-47%的人表示经常面临道德挑战的情况，51%-91%的人表示与这种情况有关的干扰程度很高。不确定的人员配置、护理的连续性挑战以及患者/家庭咨询的有限机会构成了跨时间和职业的频繁的道德挑战。在受访者中，14%的人在2021年和18%的人在2022年考虑过因道德困境而辞职。两个时间点之间的结果总体上没有显著差异。结论：瑞典MNHCWs在COVID-19大流行期间普遍经历道德困境。在医疗保健系统工作条件紧张的情况下，可能需要针对潜在原因的干预措施，以确保MNHCWs的福祉。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Obstetricia et Gynecologica Scandinavica 医学-妇产科学

CiteScore

8.00

自引率

4.70%

发文量

180

审稿时长

3-6 weeks

期刊介绍： Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical, basic and translational research work related to all aspects of women’s health from around the globe. The journal regularly publishes commentaries, reviews, and original articles on a wide variety of topics including: gynecology, pregnancy, birth, female urology, gynecologic oncology, fertility and reproductive biology.