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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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  • Michele Villa

    (Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900 Lugano, Switzerland
    These authors contributed equally to this work.)

  • Colette Balice-Bourgois

    (Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland)

  • Angela Tolotti

    (Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland)

  • Anna Falcó-Pegueroles

    (School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain), Campus Bellvitge, Pavelló de Govern, 3a planta, Despatx 331, Feixa Llarga, s/n L’Hospitalet de Llobregat, 08907 Barcelona, Spain)

  • Serena Barello

    (EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy)

  • Elena Corina Luca

    (Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland)

  • Luca Clivio

    (ICT Data Science & Research Unit, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland)

  • Annette Biegger

    (Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzonal, Switzerland)

  • Dario Valcarenghi

    (Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
    Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland)

  • Loris Bonetti

    (Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
    Department of Business Economics, University of Applied Sciences and Arts of Southern Switzerland, Health and Social Care, Via Violino, 11, 6928 Manno, Switzerland
    These authors contributed equally to this work.)

Abstract

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 rs (546) = 0.453, p < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; p < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; p < 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.

Suggested Citation

  • Michele Villa & Colette Balice-Bourgois & Angela Tolotti & Anna Falcó-Pegueroles & Serena Barello & Elena Corina Luca & Luca Clivio & Annette Biegger & Dario Valcarenghi & Loris Bonetti, 2021. "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," IJERPH, MDPI, vol. 18(22), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12012-:d:680162
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    References listed on IDEAS

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    1. Serena Barello & Anna Falcó-Pegueroles & Debora Rosa & Angela Tolotti & Guendalina Graffigna & Loris Bonetti, 2020. "The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(7), pages 1205-1216, September.
    2. John Horn, 1965. "A rationale and test for the number of factors in factor analysis," Psychometrika, Springer;The Psychometric Society, vol. 30(2), pages 179-185, June.
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    Cited by:

    1. Debora Rosa & Loris Bonetti & Giulia Villa & Sara Allieri & Riccardo Baldrighi & Rolando Francesco Elisei & Paola Ripa & Noemi Giannetta & Carla Amigoni & Duilio Fiorenzo Manara, 2022. "Moral Distress of Intensive Care Nurses: A Phenomenological Qualitative Study Two Years after the First Wave of the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(22), pages 1-15, November.
    2. Colette Balice-Bourgois & Loris Bonetti & Angela Tolotti & Sarah Jayne Liptrott & Michele Villa & Corina Elena Luca & Laura Maria Steiner & Annette Biegger & Silvia Goncalves & Laura Moser & Antonio P, 2022. "Experiences and Needs of Patients, Caregivers and Nurses during the COVID-19 Pandemic: Study Protocol for a Mixed-Methods Multicentre Study," IJERPH, MDPI, vol. 19(19), pages 1-9, October.

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