News Release

When the going gets tough: Challenges faced by healthcare workers during COVID-19 pandemic

Researchers from Osaka University identify ethical and social issues faced by frontline healthcare workers during the COVID-19 pandemic in Japan, highlighting limited communication and life-sustaining treatment

Peer-Reviewed Publication

Osaka University


image: Impact of the COVID-19 pandemic on the medical care system (based on healthcare providers’ answers to multiple choice questions) view more 

Credit: © 2021 Yusuke Seino et al., Asian Bioethics Review

Osaka, Japan –In the early stages of the COVID-19 pandemic, while many of us remained in the safety of our own homes, frontline healthcare workers faced a sudden influx of patients with the new, highly contagious, life-threatening disease. This undoubtedly caused a great deal of stress among hospital staff. But what exactly were the most difficult aspects from the point of view of the healthcare workers themselves? Researchers from Osaka University have investigated this by conducting a survey of intensive care workers’ experiences in Japan. The results, published this month in Asian Bioethics Review, have revealed a number of ethical and social issues that were particularly challenging, including limited communication and life-sustaining treatment.

“We sent a questionnaire to members of the Japanese Society of Intensive Care Medicine in July 2020,” says lead author of the study, Yusuke Seino. “We received responses from 189 healthcare workers who had been involved in treating patients with COVID-19. We found that more than half of the respondents had experienced moral distress during the pandemic. This typically occurs when workers find that they are unable to provide patients with the care that they need.”

Although moral distress is not uncommon among intensive care workers even in normal times, the research team was particularly concerned about it during the pandemic.

“Moral distress can lead to burnout,” explains Seino. “This has a negative impact on the healthcare system and is particularly problematic during a pandemic. To compound the issue, many workers reported less mental support for healthcare staff following the COVID-19 outbreak.”

The research team focused on analyzing the causes of the distress and on identifying other social and ethical issues that were encountered.

“We found that there were difficulties that stemmed from infection control measures and visiting restrictions,” says Kazuto Kato, senior author. “These included limited communication with patients, their families, and other healthcare professionals, which made it difficult to make patient-centered decisions and provide appropriate support. There were also difficulties involved in treating patients, because there were unusual restrictions in place and a lack of protective equipment. We also identified other important issues, such as social discrimination against healthcare workers due to the widespread fear of COVID-19.”

So, what can be done to improve the situation?

This study identifies some key areas that need improvement and offers potential solutions for them. “There are several measures that could be adopted,” says Kato. “For instance, virtual communication could be used in hospitals and more psychological support could be provided. These measures could help to prevent burnout and ensure appropriate medical care. We think that it’s important to address these issues in a timely manner, because the pandemic is still far from over.”


The article, “Ethical and social issues for health care providers in the intensive care unit during the early stages of the COVID-19 pandemic in Japan: a questionnaire survey,” was published in Asian Bioethics Review at DOI:


About Osaka University

Osaka University was founded in 1931 as one of the seven imperial universities of Japan and is now one of Japan's leading comprehensive universities with a broad disciplinary spectrum. This strength is coupled with a singular drive for innovation that extends throughout the scientific process, from fundamental research to the creation of applied technology with positive economic impacts. Its commitment to innovation has been recognized in Japan and around the world, being named Japan's most innovative university in 2015 (Reuters 2015 Top 100) and one of the most innovative institutions in the world in 2017 (Innovative Universities and the Nature Index Innovation 2017). Now, Osaka University is leveraging its role as a Designated National University Corporation selected by the Ministry of Education, Culture, Sports, Science and Technology to contribute to innovation for human welfare, sustainable development of society, and social transformation.




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