{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:05:20Z","timestamp":1779789920755,"version":"3.53.1"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic created unprecedented ethical challenges for nurses, often culminating in moral distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to explore the experiences of Spanish nurses in relation to moral distress and ethical conflicts experienced during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative phenomenological study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nurses who had tended COVID\u201019 patients were given a semi\u2010structured interview via the Zoom application. Thematic analysis was carried out, identifying units of meaning and assigning codes that were grouped into the different categories using Open Code software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen nurses participated and four categories emerged: (i) Difficulties in the general management of the pandemic on the institutional level, (ii) Limitation of patients\u2019 rights in a pandemic situation, (iii) Influence on the humanization of healthcare, (iv) Impact on professionals and on the profession.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Restrictions on patients\u2019 and families\u2019 rights during the pandemic generated ethical conflicts for healthcare professionals. In addition, the scarcity of both human and material resources, together with limited access to information, intensified value conflicts in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This project provides evidence on ethical conflicts experienced by nurses during the pandemic, both in the quality of care and professionals\u2019 well\u2010being. Findings will contribute to and have an impact on future action protocols and public policies aimed at better managing ethical challenges in health emergency situations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70575","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:12:00Z","timestamp":1777522320000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethical Dilemmas and Moral Distress in Health Emergencies: The Case of the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic in Spanish Nurses\u2014A Qualitative Study"],"prefix":"10.1002","volume":"13","author":[{"given":"Ver\u00f3nica","family":"T\u00edscar\u2010Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"BioBizkaia Health Research Institute  Barakaldo Spain"},{"name":"Universidad del Pa\u00eds Vasco University School of Nursing of Vitoria  Vitoria\u2010Gazteiz Spain"},{"name":"OSI Bilbao Basurto. Basque Health Service (Osakidetza)  Bilbao Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8366-1143","authenticated-orcid":false,"given":"Marta","family":"Bartolom\u00e9\u2010Ruperez","sequence":"additional","affiliation":[{"name":"Department of Sociology and Social Work University of the Basque Country (UPV\/EHU)  Leioa Spain"},{"name":"Research Group in Social Determinants of Health and Demographic Change\u2010OPIK  Leioa Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-2974","authenticated-orcid":false,"given":"Joan","family":"Blanco\u2010Blanco","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Physiotherapy. Research Group on Society, Health, Education and Culture of Care (GESEC) Universitat de Lleida  Lleida Spain"},{"name":"Research Group of Health Care (GReCS), IRBL  Lleida Spain"},{"name":"CIBERFES, Carlos III Health Institute  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-3301","authenticated-orcid":false,"given":"Carolina","family":"Da Silva\u2010Caram","sequence":"additional","affiliation":[{"name":"School of Nursing of the Universidad Federal de Minas Gerais  Belo Horizonte Brazil"},{"name":"Grupo de Estudio N\u00facleo de Pesquisa Administra\u00e7\u00e3o Em Enfermagem (NUPAE)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla Ivonne","family":"Mijangos\u2010Fuentes","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma del Estado de  Toluca Edo M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Moreno\u2010Casbas","sequence":"additional","affiliation":[{"name":"CIBERFES, Carlos III Health Institute  Madrid Spain"},{"name":"Health Care and Services Research Unit (Invest\u00e9n\u2010Isciii)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"MDCOVID\u201019 Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.22325\/fes\/res.2021.61"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.estger.2014.06.007"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_13_6_1","volume-title":"Thematic Analysis: A Practical 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