Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review

Abstract

During the COVID-19 pandemic, healthcare workers (HCWs) did not have the opportunity to provide high-quality and standard healthcare services. Research conducted during the pandemic has revealed widespread mental health problems among HCWs. Moral distress was noted as one of the critical issues that limited the performance of HCWs in providing quality care. The purpose of this scoping review was to create an overview of HCWs’ moral distress during the COVID-19 pandemic. The review was conducted according to the Arksey and O’Malley framework. A systematic literature search was performed in five database systems: Medline/PubMed, Science Direct, Scopus, ProQuest, and the Cochrane Library, according to the inclusion/exclusion criteria. Relevant article titles and abstracts were retrieved. The final review included 16 publications identifying the moral distress of HCWs during the pandemic. In total, five themes characterizing the moral distress of HCWs during the COVID-19 pandemic were identified: (1) a level of moral distress during the COVID-19 pandemic; (2) risk factors for moral distress during the COVID-19 pandemic; (3) moral and ethical dilemmas during the COVID-19 pandemic; (4) harm caused by moral distress to HCWs; and (5) intervention methods for reducing moral distress. The pandemic turned a health emergency into a mental health emergency for HCWs.

Keywords

• moral distress
• ethical dilemmas
• healthcare workers (HCWs)
• COVID-19