Objective: Research is urgently needed to understand health care workers' (HCWs') experiences of moral-ethical dilemmas encountered throughout the COVID-19 pandemic, and their associations with organizational perceptions and personal well-being. The purpose of this research is to evaluate associations between workplace experiences during COVID-19, moral distress, and the psychological well-being of Canadian HCWs. Method: A total of 1383 French- and English-speaking Canadian HCWs employed during the COVID-19 pandemic were recruited to participate in an online survey. Participants completed measures reflecting moral distress, perceptions of organizational response to the pandemic, burnout, and symptoms of psychological disorders, including depression, anxiety, and posttraumatic stress disorder. Results: Structural equation modeling showed that when organizational predictors were considered together, resource adequacy, positive work life impact, and ethical work environment negatively predicted severity of moral distress, whereas COVID-19 risk perception positively predicted severity of moral distress. Moral distress also significantly and positively predicted symptoms of depression, anxiety, PTSD, and burnout. Conclusions: Our findings highlight an urgent need for HCW organizations to implement strategies designed to prevent long-term moral and psychological distress within the workplace. Ensuring availability of adequate resources, reducing HCW risk of contracting COVID-19, providing organizational support regarding individual priorities, and upholding ethical considerations are crucial to reducing severity of moral distress in HCWs.

中文翻译：

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在COVID-19大流行期间，令人沮丧的道德经历对加拿大卫生保健工作者的心理健康的影响

目的：迫切需要进行研究，以了解医护人员（HCW）在整个COVID-19大流行中遇到的道德伦理困境的经历，以及他们与组织观念和个人福祉的关系。这项研究的目的是评估在COVID-19期间的工作场所经验，道德困扰和加拿大HCW的心理健康之间的关联。方法：共招募了1383名在COVID-19大流行期间使用法语和英语的加拿大HCW，以参加在线调查。参与者完成了反映道德苦恼，对组织对大流行的反应，倦怠和心理障碍症状（包括抑郁症，焦虑症和创伤后应激障碍）的感知的措施。结果：结构方程模型表明，将组织预测因素综合考虑时，资源充足性，积极的工作生活影响和道德的工作环境会对道德困扰的严重程度产生负面影响，而COVID-19风险感知则对道德困扰的严重程度产生正面影响。道德苦恼还可以显着，积极地预测抑郁，焦虑，创伤后应激障碍和倦怠的症状。结论：我们的发现突出表明，医护工作者组织迫切需要实施旨在防止工作场所内长期的道德和心理困扰的策略。确保有足够的资源，减少医护人员签定COVID-19的风险，提供有关个人优先事项的组织支持以及坚持道德考量对于减少医护人员的道德困扰至关重要。