Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study
Abstract Introduction Moral distress arises when healthcare workers face difficult decisions without adequate information and/or when patient care is compromised due to limited resources, communication issues, or altered work routines in exceptional circumstances. While moral distress in maternity a...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | Acta Obstetricia et Gynecologica Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/aogs.15125 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850115502994620416 |
|---|---|
| author | Patricia Ernst Karolina Linden Marta Roczniewska Emina Hadzibajramovic Anna Wessberg Ola Andersson Ylva Carlsson Sofie Graner Maria Jonsson Malin Veje Verena Sengpiel Magnus Akerstrom |
| author_facet | Patricia Ernst Karolina Linden Marta Roczniewska Emina Hadzibajramovic Anna Wessberg Ola Andersson Ylva Carlsson Sofie Graner Maria Jonsson Malin Veje Verena Sengpiel Magnus Akerstrom |
| author_sort | Patricia Ernst |
| collection | DOAJ |
| description | Abstract Introduction Moral distress arises when healthcare workers face difficult decisions without adequate information and/or when patient care is compromised due to limited resources, communication issues, or altered work routines in exceptional circumstances. While moral distress in maternity and neonatal healthcare workers (MNHCWs) has been noted, its prevalence, intensity, and impact on well‐being and turnover in Sweden remain unexplored. The aim of this study was to investigate the level of disturbance and frequency of experiencing moral distress among Swedish MNHCWs during the COVID‐19 pandemic and the effects on MNHCWs' well‐being and intention to leave their job. Material and Methods A longitudinal cohort study was conducted during January–May 2021 (n = 645) and January–March 2022 (n = 503), utilizing the Moral Distress Scale‐Revised (MDS‐R). The study was set in hospital‐based maternity and neonatal units across all 21 Swedish healthcare regions and included midwives, physicians, registered nurses, and assistant nurses. Quantitative and descriptive analyses were performed, with comparisons of moral distress levels between time points and professions. The main outcome measures were moral distress (level of disturbance and frequency) and intention to leave their job. Results Among the respondents, 6%–47% reported being frequently exposed to morally challenging situations, and 51%–91% reported a high level of disturbance in connection to such situations. Uncertain staffing, continuity‐of‐care challenges, and limited opportunities for patient/family counseling posed frequent moral challenges across time and professions. Of the respondents, 14% in 2021 and 18% in 2022 considered leaving their jobs due to moral distress. There were no overall significant differences in outcomes between the two time points. Conclusions Swedish MNHCWs commonly experienced moral distress during the COVID‐19 pandemic. Interventions targeting underlying reasons may be needed to ensure the well‐being of MNHCWs in situations when the healthcare system is under strained working conditions. |
| format | Article |
| id | doaj-art-49372ea8d5e44db4912d323dd7a6416a |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-49372ea8d5e44db4912d323dd7a6416a2025-08-20T02:36:34ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-07-0110471399140910.1111/aogs.15125Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort studyPatricia Ernst0Karolina Linden1Marta Roczniewska2Emina Hadzibajramovic3Anna Wessberg4Ola Andersson5Ylva Carlsson6Sofie Graner7Maria Jonsson8Malin Veje9Verena Sengpiel10Magnus Akerstrom11Institute of Health and Care Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg SwedenInstitute of Health and Care Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg SwedenProcome Research Group, Department of Learning, Informatics, Management and Ethics Medical Management Centre, Karolinska Institutet Stockholm SwedenSchool of Public Health and Community Medicine Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg Gothenburg SwedenInstitute of Health and Care Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg SwedenDepartment of Clinical Sciences Lund, Paediatrics Lund University Lund SwedenRegion Västra Götaland, Department of Obstetrics and Gynaecology Sahlgrenska University Hospital Gothenburg SwedenDepartment of Medicine, Centre for Pharmacoepidemiology Karolinska Institute Stockholm SwedenDepartment of Women's and Children's Health Uppsala University Uppsala SwedenDepartment of Infectious Diseases Region Västra Götaland, Sahlgrenska University Hospital Gothenburg SwedenRegion Västra Götaland, Department of Obstetrics and Gynaecology Sahlgrenska University Hospital Gothenburg SwedenSchool of Public Health and Community Medicine Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg Gothenburg SwedenAbstract Introduction Moral distress arises when healthcare workers face difficult decisions without adequate information and/or when patient care is compromised due to limited resources, communication issues, or altered work routines in exceptional circumstances. While moral distress in maternity and neonatal healthcare workers (MNHCWs) has been noted, its prevalence, intensity, and impact on well‐being and turnover in Sweden remain unexplored. The aim of this study was to investigate the level of disturbance and frequency of experiencing moral distress among Swedish MNHCWs during the COVID‐19 pandemic and the effects on MNHCWs' well‐being and intention to leave their job. Material and Methods A longitudinal cohort study was conducted during January–May 2021 (n = 645) and January–March 2022 (n = 503), utilizing the Moral Distress Scale‐Revised (MDS‐R). The study was set in hospital‐based maternity and neonatal units across all 21 Swedish healthcare regions and included midwives, physicians, registered nurses, and assistant nurses. Quantitative and descriptive analyses were performed, with comparisons of moral distress levels between time points and professions. The main outcome measures were moral distress (level of disturbance and frequency) and intention to leave their job. Results Among the respondents, 6%–47% reported being frequently exposed to morally challenging situations, and 51%–91% reported a high level of disturbance in connection to such situations. Uncertain staffing, continuity‐of‐care challenges, and limited opportunities for patient/family counseling posed frequent moral challenges across time and professions. Of the respondents, 14% in 2021 and 18% in 2022 considered leaving their jobs due to moral distress. There were no overall significant differences in outcomes between the two time points. Conclusions Swedish MNHCWs commonly experienced moral distress during the COVID‐19 pandemic. Interventions targeting underlying reasons may be needed to ensure the well‐being of MNHCWs in situations when the healthcare system is under strained working conditions.https://doi.org/10.1111/aogs.15125COVID‐19 pandemichealthcare workersmaternity healthcaremoral distressneonatal healthcareSweden |
| spellingShingle | Patricia Ernst Karolina Linden Marta Roczniewska Emina Hadzibajramovic Anna Wessberg Ola Andersson Ylva Carlsson Sofie Graner Maria Jonsson Malin Veje Verena Sengpiel Magnus Akerstrom Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study Acta Obstetricia et Gynecologica Scandinavica COVID‐19 pandemic healthcare workers maternity healthcare moral distress neonatal healthcare Sweden |
| title | Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study |
| title_full | Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study |
| title_fullStr | Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study |
| title_full_unstemmed | Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study |
| title_short | Moral distress among maternity and neonatal healthcare workers during the COVID‐19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study |
| title_sort | moral distress among maternity and neonatal healthcare workers during the covid 19 pandemic in sweden results from the cope staff longitudinal cohort study |
| topic | COVID‐19 pandemic healthcare workers maternity healthcare moral distress neonatal healthcare Sweden |
| url | https://doi.org/10.1111/aogs.15125 |
| work_keys_str_mv | AT patriciaernst moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT karolinalinden moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT martaroczniewska moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT eminahadzibajramovic moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT annawessberg moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT olaandersson moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT ylvacarlsson moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT sofiegraner moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT mariajonsson moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT malinveje moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT verenasengpiel moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy AT magnusakerstrom moraldistressamongmaternityandneonatalhealthcareworkersduringthecovid19pandemicinswedenresultsfromthecopestafflongitudinalcohortstudy |