{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:29:38Z","timestamp":1790778578744,"version":"4.1.0"},"reference-count":54,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Royal Melbourne Hospital Foundation","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Lord Mayor\u2019s Charitable Foundation","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. Methods: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations, or colleges, universities, government contacts, and national media. Results: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%), or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with increased risk of anxiety, depression, post-traumatic stress disorder, and burnout. Conversely, feeling appreciated by the community protected against these risks in healthcare workers. Conclusions: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.<\/jats:p>","DOI":"10.3390\/ijerph18168723","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T10:54:35Z","timestamp":1629284075000},"page":"8723","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Moral Distress and Perceived Community Views Are Associated with Mental Health Symptoms in Frontline Health Workers during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-3586","authenticated-orcid":false,"given":"Natasha","family":"Smallwood","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, The Alfred Hospital, Prahan, VIC 3004, Australia"},{"name":"Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3555-6856","authenticated-orcid":false,"given":"Amy","family":"Pascoe","sequence":"additional","affiliation":[{"name":"Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Karimi","sequence":"additional","affiliation":[{"name":"School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia"},{"name":"School of Medicine and Healthcare Management, Caucasus University, Tbilisi 0102, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Willis","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Health and Biomedicine, Victoria University, Footscray Park, Melbourne, VIC 3011, Australia"},{"name":"Division of Critical Care and Investigative Services, Royal Melbourne Hospital, Grattan Street Parkville, Melbourne, VIC 3050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1111\/famp.12580","article-title":"The Witness to Witness Program: Helping the Helpers in the Context of the COVID-19 Pandemic","volume":"59","author":"Weingarten","year":"2020","journal-title":"Fam. 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