{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:48:58Z","timestamp":1768340938418,"version":"3.49.0"},"reference-count":49,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses\u2019 ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not. Methods: Design\u2014Multicentre online survey. Setting\u2014Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman\u2019s rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses\u2019 characteristics and outcome variables, and the Mann\u2013Whitney\/t-test to compare groups. Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low\u2013moderate level of ethical conflict (median = 111.5 [76\u2013152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress rs (546) = 0.453, p &lt; 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96\u201313.01; p &lt; 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56\u20139.6; p &lt; 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict. Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.<\/jats:p>","DOI":"10.3390\/ijerph182212012","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T11:32:03Z","timestamp":1637062323000},"page":"12012","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ethical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0898-8127","authenticated-orcid":false,"given":"Michele","family":"Villa","sequence":"first","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-0242","authenticated-orcid":false,"given":"Colette","family":"Balice-Bourgois","sequence":"additional","affiliation":[{"name":"Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2834-4345","authenticated-orcid":false,"given":"Angela","family":"Tolotti","sequence":"additional","affiliation":[{"name":"Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3702-3009","authenticated-orcid":false,"given":"Anna","family":"Falc\u00f3-Pegueroles","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain), Campus Bellvitge, Pavell\u00f3 de Govern, 3a planta, Despatx 331, Feixa Llarga, s\/n L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8514-2563","authenticated-orcid":false,"given":"Serena","family":"Barello","sequence":"additional","affiliation":[{"name":"EngageMinds HUB\u2014Consumer, Food & Health Engagement Research Center, Department of Phychology, Universit\u00e0 Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8004-4550","authenticated-orcid":false,"given":"Elena Corina","family":"Luca","sequence":"additional","affiliation":[{"name":"Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Clivio","sequence":"additional","affiliation":[{"name":"ICT Data Science & Research Unit, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Biegger","sequence":"additional","affiliation":[{"name":"Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzonal, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-3356","authenticated-orcid":false,"given":"Dario","family":"Valcarenghi","sequence":"additional","affiliation":[{"name":"Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland"},{"name":"Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0694-0880","authenticated-orcid":false,"given":"Loris","family":"Bonetti","sequence":"additional","affiliation":[{"name":"Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland"},{"name":"Department of Business Economics, University of Applied Sciences and Arts of Southern Switzerland, Health and Social Care, Via Violino, 11, 6928 Manno, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, June 17). 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