{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T21:28:58Z","timestamp":1763069338662,"version":"build-2065373602"},"reference-count":84,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"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>In the modern healthcare landscape, moral distress has become an increasingly common phenomenon among healthcare professionals. This condition is particularly prevalent among palliative care professionals who are confronted with bioethical issues in their daily practice. Although some studies described the effects of poor ethical climate and negative affectivity on moral distress, how these variables could be incorporated into a single model is still unclear. Thus, this study aims to investigate whether ethical relationships with the hospital could be related to the intensity and frequency of moral distress, both directly and as mediated by professionals\u2019 negative affectivity. Sixty-one Portuguese palliative care professionals completed web-based self-report questionnaires. After exploring descriptive statistics, mediation analyses were performed using the partial least squares method. The results indicated that the presence of positive relationships with the hospital reduced the professionals\u2019 negative affectivity levels. This, in turn, led palliative care professionals to experience a lower frequency and intensity of moral distress. Being a physician was positively associated with negative affectivity but not with the frequency of moral distress. Considering the protective role of ethical relationships with hospitals, health organizations could consider implementing interventions to improve hospitals\u2019 ethical climate and provide staff with ethics training programs.<\/jats:p>","DOI":"10.3390\/ijerph19073863","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:05:18Z","timestamp":1648166718000},"page":"3863","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["How Supportive Ethical Relationships Are Negatively Related to Palliative Care Professionals\u2019 Negative Affectivity and Moral Distress: A Portuguese Sample"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-7895","authenticated-orcid":false,"given":"Francisca","family":"Rego","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Valentina","family":"Sommovigo","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, 27100 Pavia, Italy"},{"name":"Department of Management, University of Bologna-Rimini Campus, 47900 Rimini, Italy"}]},{"given":"Ilaria","family":"Setti","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, 27100 Pavia, Italy"}]},{"given":"Anna","family":"Giardini","sequence":"additional","affiliation":[{"name":"IT Department, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy"}]},{"given":"Elsa","family":"Alves","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Julliana","family":"Morgado","sequence":"additional","affiliation":[{"name":"Institute of Philosophy and Human Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3360-7293","authenticated-orcid":false,"given":"Marina","family":"Maffoni","sequence":"additional","affiliation":[{"name":"Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization, W. 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