Moral distress among infection prevention and control professionals: A scoping review.

Matt Mason, Byeonghun Im, Jocelyne M Basseal, Peta-Anne Zimmerman
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Abstract

Background: The COVID-19 pandemic highlighted the vital role of Infection Prevention and Control Professionals (IPCPs) in safeguarding public health. Amid rapidly evolving guidelines, critical personal protective equipment shortages, and surging workloads, IPCPs encountered unprecedented moral and ethical dilemmas. However, their experiences, ethical challenges, and the resulting moral distress remain understudied.

Methods: A scoping review following Arksey and O'Malley's methodology was conducted to examine current research on ethical challenges and moral distress among IPCPs. Searches in CINAHL, MEDLINE via OVID, Emcare, Scopus, and Korea Citation Index yielded two extracted articles.

Results: Common themes included high workload, increased recognition, pressure to deliver accurate and timely information, need for peer support, and evidence-based practice. Differences in nationality, role discretion, and administrative systems led to varied experiences. District Medical Officers in Norway experienced more decision-making responsibilities and resulting ethical dilemmas in the context of broader communities and municipalities. The experiences of IPCPs were confined to their respective healthcare facilities.

Conclusion: There is a dearth of available research reporting the moral distress experienced by IPCPs whilst there is a plethora for those seen as "frontline" workers. Given the integral decision-making and implementation roles of these health professionals, and the burdens of ethical dilemmas they experienced in pandemic preparedness and response, further research is imperative to inform strategies to build moral resilience in the future.

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感染预防与控制专业人员的精神压力:范围审查。
背景:COVID-19 大流行凸显了感染预防与控制专业人员 (IPCP) 在保障公共卫生方面的重要作用。在指导方针迅速演变、个人防护设备严重短缺和工作量激增的情况下,IPCPs 遇到了前所未有的道德和伦理困境。然而,他们的经历、伦理挑战以及由此产生的道德困扰仍未得到充分研究:方法:我们按照 Arksey 和 O'Malley 的方法进行了一次范围界定研究,以考察当前有关 IPCPs 所面临的伦理挑战和道德困扰的研究。在 CINAHL、MEDLINE via OVID、Emcare、Scopus 和韩国引文索引中进行了检索,共摘录了两篇文章:共同的主题包括工作量大、认可度提高、提供准确及时信息的压力、需要同行支持以及循证实践。国籍、角色自由裁量权和行政制度的不同导致了不同的经验。挪威的地区医务官员在更广泛的社区和市政范围内承担了更多的决策责任,并因此遇到了道德难题。IPP的经验则局限于各自的医疗机构:有关 IPCPs 所经历的道德困境的研究报告很少,而有关被视为 "一线 "工作者的研究报告却很多。鉴于这些卫生专业人员在决策和执行方面的重要作用,以及他们在大流行病防备和应对过程中所经历的道德困境的负担,进一步的研究势在必行,以便为未来建立道德复原力的战略提供信息。
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