Moral distress in healthcare personnel during Covid-19 pandemic: Experience from Piacenza Oncology Department

Background: Italy has been one of the countries most affected by Covid-19 emergency, in particular Piacenza has reached the record for the number of victims caused by the virus and is still facing a copious number of infections The healthcare staff of Piacenza Hospital faced this emergency demonstrating a strong spirit of adaptation, alleviating suffering, loneliness and leading many patients infected with the virus towards healing Moral distress is a common reaction in morally difficult situations, and includes feelings of frustration and lack of power when healthcare professionals are prevented from acting in accordance with their values and ideals (Gustavsson et al, 2019) Morally demanding choices add a greater burden to working in an already stressful environment The Covid-19 emergency as a pandemic can be considered a real catastrophe, characterized by health needs that exceed existing capacities and so often health professionals have had to make difficult decisions, quickly choose who to treat and how to use optimal limited resources available The study aims to investigate the Moral Distress of oncologic operators of Piacenza Oncology during Covid-19 emergency period Material and methods: We conducted an observational qualitative study, the data collection tool is a semi-structured interview, consisting of sequential and standardized questions 26 operators were interviewed (8 doctors, 13 nurses and 5 OSS) who worked in the Medical Oncology Unit of Piacenza hospital during the emergency period The data analysis took place with analysis of the thematic content Qualitative analysis involves the fragmentation of data into simpler units and the subsequent recomposition in new ways Results: The results of the interviews were divided into four macrocodes: Sensations associated with Moral Distress, Negative episodes, Changes, Positive episodes, in turn divided into several microcodes The Moral Distress therefore emerges that this pandemic has evoked in operators despite their professionalism and preparation for end of life Conclusions: Moral Distress is a usual condition for Oncology operators who are used to being in contact with suffering and death, caused by the high psychological and physical contact that is established with the sick person, but the results of our work highlighted how the pandemic has changed the care and perception of operators, intensifying this feeling of psychological imbalance