ArticleJournal of advanced nursing2022
Hospital nurses' moral distress and mental health during COVID-19.
Article in Journal of advanced nursing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 4 of them syntheses that pooled it.
What it found
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Who cites it
103 citing papers in PubMed, 4 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Organizational interventions to support and promote the mental health of healthcare workers during pandemics and epidemics: a systematic review.BMC health services research · 2025Pooled it
- Severity and associated factors of moral injury in healthcare workers during the coronavirus pandemic: a comprehensive meta-analysis.Archives of public health = Archives belges de sante publique · 2025Pooled it
- Estimation of moral distress among nurses: A systematic review and meta-analysis.Nursing ethics · 2023Pooled it
- Guideline
- Equitable Discharge Teaching During COVID-19: Paediatric Emergency Nurses' Perspectives From Qualitative Interviews.Journal of advanced nursing · 2026Article
- Magnet Recognition, Leadership Responsiveness, and Nurse Moral Distress: A Multilevel Mediation Analysis.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Observational
- Moral Resilience and Its Associations with Workplace Gaslighting and Quiet Quitting: A Cross-Sectional Study of White-Collar Workers in Greece.Healthcare (Basel, Switzerland) · 2026Article
- Clinician Distress in the Care of Seriously Ill Hospitalized Patients: A Mixed Methods Integration of Qualitative Findings and a Quantitative Typology.Research square · 2026Article
- The impact of narrative exposure therapy on dysthymia and post-traumatic stress symptoms in nurses in the post COVID-19 period: a randomized clinical trial study.BMC nursing · 2026Article
- Article
- Work environment of nurses and technicians in Brazilian Intensive Care Units during the COVID-19 pandemic: a multicenter cross-sectional study.BMC health services research · 2026Article
- Ethical performance predicts missed nursing care in critical and general care settings.Scientific reports · 2026Article
- Moral distress of primary health care workers during the global pandemic.Scientific reports · 2026Article
- Guilt, Not Shame, Mediates the Longitudinal Relationship Between Moral Distress and Suicidal Ideation Among Frontline Nurses During COVID-19.Journal of clinical psychology · 2026Article
- The relationship between role clarity and compulsory citizenship behavior among junior nurses: evidence from network analysis and simulation-based network modeling.Frontiers in public health · 2026Article
- Family satisfaction and healthcare providers' moral distress in intensive care units: a cross-sectional study.Scientific reports · 2025Article
- Strengthening healthcare readiness: Lessons from frontline nurses in a South African tertiary hospital for future pandemic preparedness.International emergency nursing · 2025Article
- Exposure to distressing situations among registered nurses during the COVID-19 pandemic: a cross-sectional study.BMC nursing · 2025Article
- Work-related stress of nurses in Poland and Lithuania: countries under the influence of war circumstances in Ukraine.BMC nursing · 2025Article
- How Nursing Home Nurses Who Care for Residents With Dementia Experience the Moral Distress? A Phenomenography Study.Nursing open · 2025Article
43 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
aimsTo explore factors associated with nurses' moral distress during the first COVID-19 surge and their longer-term mental health.
designCross-sectional, correlational survey study.
methodsRegistered nurses were surveyed in September 2020 about their experiences during the first peak month of COVID-19 using the new, validated, COVID-19 Moral Distress Scale for Nurses. Nurses' mental health was measured by recently experienced symptoms. Analyses included descriptive statistics and regression analysis. Outcome variables were moral distress and mental health. Explanatory variables were frequency of COVID-19 patients, leadership communication and personal protective equipment/cleaning supplies access. The sample comprised 307 nurses (43% response rate) from two academic medical centres.
resultsMany respondents had difficulty accessing personal protective equipment. Most nurses reported that hospital leadership communication was transparent, effective and timely. The most distressing situations were the transmission risk to nurses' family members, caring for patients without family members present, and caring for patients dying without family or clergy present. These occurred occasionally with moderate distress. Nurses reported 2.5 days each in the past week of feeling anxiety, withdrawn and having difficulty sleeping. Moral distress decreased with effective communication and access to personal protective equipment. Moral distress was associated with longer-term mental health.
conclusionPandemic patient care situations are the greatest sources of nurses' moral distress. Effective leadership communication, fewer COVID-19 patients, and access to protective equipment decrease moral distress, which influences longer-term mental health. IMPACT: Little was known about the impact of COVID-19 on nurses' moral distress. We found that nurses' moral distress was associated with the volume of care for infected patients, access to personal protective equipment, and communication from leaders. We found that moral distress was associated with longer-term mental health. Leaders should communicate transparently to decrease nurses' moral distress and the negative effects of global crises on nurses' longer-term mental health.
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What OpenQuestion holds
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.