Abstract：
OBJECTIVE: The aim of this work was to determine the impact of Moral Distress (MD) in emergency physicians, nurses, and emergency medical service staff at the Rand Memorial Hospital (RMH) in the Bahamas, and the impact of Hurricane Dorian and the COVID-19 pandemic on Moral Distress.
METHODS: A cross-sectional study utilizing a 3-part survey, which collected sociodemographic information, Hurricane Dorian and COVID-19 experiences, as well as responses to a validated modified Moral Distress Scale (MDS).
RESULTS: Participants with 2 negatively impactful experiences from COVID-19 had statistically significantly increased MD compared to participants with only 1 negatively impactful experience (40.4 vs. 23.6, P = 0.014). Losing a loved one due to COVID-19 was associated with significantly decreased MD (B = - 0.42, 95% CI -19.70 to -0.88, P = 0.03). Losing a loved one due to Hurricane Dorian had a non-statistically significant trend towards higher MD scores (B = 0.34, 95% CI -1.23 to 28.75, P = 0.07).
CONCLUSIONS: The emergency medical staff at the RMH reported having mild - moderate MD. This is one of the first studies to look at the impact of concurrent disasters on MD in emergency medical providers in the Bahamas.
METHODS: A cross-sectional study utilizing a 3-part survey, which collected sociodemographic information, Hurricane Dorian and COVID-19 experiences, as well as responses to a validated modified Moral Distress Scale (MDS).
RESULTS: Participants with 2 negatively impactful experiences from COVID-19 had statistically significantly increased MD compared to participants with only 1 negatively impactful experience (40.4 vs. 23.6, P = 0.014). Losing a loved one due to COVID-19 was associated with significantly decreased MD (B = - 0.42, 95% CI -19.70 to -0.88, P = 0.03). Losing a loved one due to Hurricane Dorian had a non-statistically significant trend towards higher MD scores (B = 0.34, 95% CI -1.23 to 28.75, P = 0.07).
CONCLUSIONS: The emergency medical staff at the RMH reported having mild - moderate MD. This is one of the first studies to look at the impact of concurrent disasters on MD in emergency medical providers in the Bahamas.
摘要：
目的：这项工作的目的是确定道德困扰（MD）对急诊医师的影响，护士,和巴哈马兰德纪念医院（RMH）的紧急医疗服务人员，以及多里安飓风和新冠肺炎大流行对道德困扰的影响。
方法：采用3部分调查的横断面研究，收集社会人口统计信息，多里安飓风和COVID-19经历，以及对经过验证的修改的道德困扰量表(MDS)的响应。
结果：与仅有1次负面影响经验的参与者相比，有2次负面影响经验的参与者在统计学上显着增加MD（40.4vs.23.6,P=0.014)。因COVID-19失去亲人与MD明显降低相关(B=-0.42，95%CI-19.70至-0.88，P=0.03)。由于多里安飓风而失去亲人的MD得分趋势无统计学意义（B=0.34，95％CI-1.23至28.75，P=0.07）。
结论：RMH的急诊医务人员报告患有轻度-中度MD。这是第一批研究同时发生的灾难对巴哈马紧急医疗提供者的MD的影响的研究之一。
方法：采用3部分调查的横断面研究，收集社会人口统计信息，多里安飓风和COVID-19经历，以及对经过验证的修改的道德困扰量表(MDS)的响应。
结果：与仅有1次负面影响经验的参与者相比，有2次负面影响经验的参与者在统计学上显着增加MD（40.4vs.23.6,P=0.014)。因COVID-19失去亲人与MD明显降低相关(B=-0.42，95%CI-19.70至-0.88，P=0.03)。由于多里安飓风而失去亲人的MD得分趋势无统计学意义（B=0.34，95％CI-1.23至28.75，P=0.07）。
结论：RMH的急诊医务人员报告患有轻度-中度MD。这是第一批研究同时发生的灾难对巴哈马紧急医疗提供者的MD的影响的研究之一。
