• Rachel A Plouffe, Anthony Nazarov, Callista A Forchuk, Dominic Gargala, Erisa Deda, Tri Le, Jesse Bourret-Gheysen, Brittni Jackson, Vanessa Soares, Fardous Hosseiny, Patrick Smith, Maya Roth, Arlene G MacDougall, Michelle Marlborough, Rakesh Jetly, Alexandra Heber, Joy Albuquerque, Ruth Lanius, Ken Balderson, Gabrielle Dupuis, Viraj Mehta, and J Don Richardson.
• The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
• Eur J Psychotraumatol. 2021 Jan 1; 12 (1): 1984667.

BackgroundResearch 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. This research is important to prevent long-term moral and psychological distress and to ensure that workers can optimally provide health services.ObjectiveEvaluate associations between workplace experiences during COVID-19, moral distress, and the psychological well-being of Canadian HCWs.MethodA total of 1362 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 (PTSD).ResultsStructural equation modelling 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.ConclusionsOur 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.© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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