Sayyed Reza Ahmadi - . Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Elnaz Vafadar-Moradi - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahmoud Mahmoudi - Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Sayyed Majid Sadrzadeh - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Majid Khadem-Rezaiyan - Clinical Research Development Unit Akbar hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Asma Nakhaei - Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahdi Foroughian - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: The spread of new coronavirus in the world and its intensification as a pandemic has challenged the world health system. Meanwhile, physicians and nurses at the forefront of the fight against this disease, due to its emergence and lack of treatment resources may face ethical challenges in treating patients.  Methods:  This cross-sectional study was performed in ۲۰۲۰ on nurses and physicians working in hospitals affiliated to Mashhad University of Medical Sciences, who were in contact with patients with COVID-۱۹. Moral distress was measured using the Corley Questionnaire. Data analysis was performed using SPSS software version ۱۸ and descriptive and inferential tests.  Results:  ۱۱۷ nurses and physicians involved with patients with the COVID-۱۹ in hospitals in Mashhad participated in the study. ۶۷.۵% were nurses and ۳۲.۵% were physicians. The majority of them were women (۶۵%) and more than half of them had a bachelor's degree (۵۵.۶%). ۷۰.۹% of them had direct contact with COVID-۱۹ patients. The frequency of the level of moral distress in the majority of personnel involved with patients with coronavirus was moderate (۶۶.۷). Also, the severity of distress and its recurrence in personnel were ۶۶.۷% and ۶۵.۸%, respectively. The level of severe moral distress in nurses (۳۲.۹%) was higher than physicians (۲۸.۹%). Also, the severity and recurrence of moral distress were reported in nurses higher than physicians.  Conclusion:  Nurses, as the group that has the most duration and intensity of contact with patients with coronavirus, experience more moral distress than physicians. However, the level of moral distress in physicians could not be ignored. This highlights the need for guidelines to address these ethical challenges. Identifying these challenges should be on the agenda of future qualitative studies.

Moral distress, Nurses, Physicians, Coronavirus, COVID ۱۹.