Evidence map›Paper›PMID 41681084›Full record

ArticleNursing open2026

Moral Distress Among Nurses During the COVID-19 Pandemic: A Cross-Sectional Survey.

Anna Sydor, Bethan Jones, Chris Bundy, Dean Whybrow, Tim Pickles, Rachael Pattinson, Rachael Hewitt, Eunice Temeng, Carys Dale, Richard G Kyle and 1 more

Abstract read
In one paragraph

Article in Nursing open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anna SydorSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-7448-5819
Bethan JonesUniversity of West of England, Bristol, UK.ORCID https://orcid.org/0000-0002-7253-0751
Chris BundySchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-5981-3984
Dean WhybrowSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0001-9066-6196
Tim PicklesCentre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0001-7743-0234
Rachael PattinsonSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-3145-3710
Rachael HewittSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-3829-5604
Eunice TemengSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-0693-4504
Carys DalePublic Health Wales, Cardiff, UK.ORCID https://orcid.org/0009-0008-4899-3909
Richard G KyleAcademy of Nursing, University of Exeter, Exeter, UK.ORCID https://orcid.org/0000-0002-6394-109X
Tessa WattsSchool of Healthcare Sciences, Cardiff University, Cardiff, UK.ORCID https://orcid.org/0000-0002-1201-5192

Funding

Burdett Trust for Nursing 632974
6 · The paper itself

Abstract

aimTo examine factors related to moral distress among registered nurses and nursing students during the severe acute respiratory syndrome COVID-19 pandemic.

designCross-sectional survey study.

methods287 registered nurses and nursing students in Wales, UK were invited to participate in an online survey between 26 October 2021 and 11 April 2022. Outcome measures used were Moral Distress for Health Professionals (MMD-HP), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and International Trauma Questionnaire (ITQ). Free text responses were collected, which allowed for exploration of moral distress, support received, pandemic preparedness and career intentions.

resultsMoral distress was significantly associated with depression; high moral distress scores were reported by those who had been redeployed; those with 2-6 years post-registration experience who cared for > 40 patients with suspected or confirmed COVID-19; and those who did not intend to remain in the nursing workforce. Qualitative findings identified: (1) an interplay between trauma experienced at home and work; (2) unhealthy coping strategies; (3) feeling unprepared and unsupported; (4) changes to roles or careers; and (5) renewed commitment to the nursing profession.

conclusionsHigh levels of moral distress and an association with depression were found among nurses working during the pandemic in Wales. Exceptional workforce pressures and their impact during this period cannot be ignored. As these pressures have not abated and sequelae likely continue, interventions that address moral distress and depression among the nursing workforce remain necessary. IMPACT: Working during the pandemic had an impact on nurses and nursing students. The link between moral distress and depression was observed as well as unanticipated impacts of moral distress. REPORTING

methodThis paper adheres to the STROBE Statement guidelines for reporting cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. However, registered nurses who were deployed during the first Covid-19 wave contributed to the study design.

Indexed as

COVID-19NursesStudents, NursingAdultCross-Sectional StudiesDepressionEthical DilemmasFemaleHumansMaleMiddle AgedPandemicsSARS-CoV-2Surveys and QuestionnairesWalesCOVID‐19cross‐sectional surveydepressionmoral distressnursing studentsregistered nursesSARS COV 2

Identifiers

PMID41681084
PMCPMC12901671

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.