ArticleDepression and anxiety2021
Moral distress in frontline healthcare workers in the initial epicenter of the COVID-19 pandemic in the United States: Relationship to PTSD symptoms, burnout, and psychosocial functioning.
Article in Depression and anxiety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05766852 (Potential Benefits of the Somatic Psychoeducational Intervention for Improving the Health and Wellness of Healthcare Providers), which is not on this map. Cited by 89 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Potential Benefits of the Somatic Psychoeducational Intervention for Improving the Health and Wellness of Healthcare Providers
Who cites it
89 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors of developing psychological problems among frontline healthcare professionals working in the COVID-19 pandemic era: a meta-analysis.BMC public health · 2023Pooled it
- Violence, Stigma, and Moral Injury in Nursing During the COVID-19 Pandemic: A Qualitative Analysis From 18 Countries in Latin America and the Caribbean.Nursing inquiry · 2026Article
- Mapping the conceptualisation, contributing factors and interventions of moral distress among healthcare providers in Africa: a scoping review.BMJ global health · 2026Article
- Burnout and posttraumatic stress among nurses in German care homes: a cross-sectional survey during the COVID-19 pandemic.BMC nursing · 2026Article
- Detection of Microbehavior Intervals for Predicting Mental Health: Clinically Relevant and Advanced Multimodal Temporal Analysis.Journal of medical Internet research · 2026Article
- Burnout and Insomnia Among Greek Physicians Affiliated with the Athens Medical Association After the Acute Phase of the COVID-19 Pandemic: Prevalence and Contributing Factors.Epidemiologia (Basel, Switzerland) · 2026Article
- Post-traumatic stress symptom trajectories following exposure to population-level trauma: findings from the COVID-19 Healthcare Staff Wellbeing Survey.BJPsych open · 2026Article
- Moral distress of primary health care workers during the global pandemic.Scientific reports · 2026Article
- Maritime Response and Emergency Care for Irregular Migrants: Experiences of Spanish Rescue Professionals.Healthcare (Basel, Switzerland) · 2026Article
- Prevalence of Moral Injury in Nationally Representative Samples of Combat Veterans, Healthcare Workers, and First Responders.Journal of general internal medicine · 2026Article
- Physician burnout in Maryland: young female physicians at highest risk during COVID-19.Annals of medicine · 2025Article
- Prevalence of Exposures and Moral Injury in First Responders.Journal of the American College of Emergency Physicians open · 2025Article
- Exploration of Nurses' Experiences Related to Moral Injury: A Reflexive Thematic Analysis of Nurse Interviews.Journal of advanced nursing · 2025Article
- Experiences of Moral Distress in Canadian Intensive Care Unit Professionals During and After the COVID-19 Pandemic: A Qualitative Exploratory Multiple Case Study in Ontario and Alberta, Canada.Journal of intensive care medicine · 2025Article
- Physician Moral Injury During the COVID-19 Pandemic.Journal of general internal medicine · 2025Article
- The Association Between Personal, Relational, Organizational and National Resilience Resources and Dietitians' Well-Being During Protracted Conflict: A Cross-Sectional Study.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025Article
- Self-compassion, mindfulness, and emotion regulation predict multiple dimensions of quality of life in US post-9/11 veterans.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Psychometric properties of the Czech moral injury symptom scale.Scientific reports · 2025Article
- Article
- Developing an evidence-and ethics-informed intervention for moral distress.Nursing ethics · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
introductionLittle is known about the relationship between moral distress and mental health problems. We examined moral distress in 2579 frontline healthcare workers (FHCWs) caring for coronavirus disease 2019 (COVID-19) patients during the height of the spring 2020 pandemic surge in New York City. The goals of the study were to identify common dimensions of COVID-19 moral distress; and to examine the relationship between moral distress, and positive screen for COVID-19-related posttraumatic stress disorder (PTSD) symptoms, burnout, and work and interpersonal functional difficulties.
methodData were collected in spring 2020, through an anonymous survey delivered to a purposively-selected sample of 6026 FHCWs at Mount Sinai Hospital; 2579 endorsed treating COVID-19 patients and provided complete survey responses. Physicians, house staff, nurses, physician assistants, social workers, chaplains, and clinical dietitians comprised the sample.
resultsThe majority of the sample (52.7%-87.8%) endorsed moral distress. Factor analyses revealed three dimensions of COVID-19 moral distress: negative impact on family, fear of infecting others, and work-related concerns. All three factors were significantly associated with severity and positive screen for COVID-19-related PTSD symptoms, burnout, and work and interpersonal difficulties. Relative importance analyses revealed that concerns about work competencies and personal relationships were most strongly related to all outcomes.
conclusionMoral distress is prevalent in FHCWs and includes family-, infection-, and work-related concerns. Prevention and treatment efforts to address moral distress during the acute phase of potentially morally injurious events may help mitigate risk for PTSD, burnout, and functional difficulties.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.