<![CDATA[Healthcare professionals face clinical demands, resource constraints, and ethical challenges that may cause moral distress when they cannot act according to their moral judgment, potentially harming mental health. This study systematically examined the association between moral distress and mental health outcomes among healthcare professionals. A systematic literature review followed PRISMA 2020, searching PubMed, Google Scholar, ScienceDirect, and Garuda for Indonesian- and English-language studies published between 2015 and 2025. Of 107 identified articles, 18 primary studies met eligibility criteria. Higher moral distress was consistently associated with depression, anxiety, psychological distress, PTSD symptoms, poorer psychological well-being, and burnout, particularly emotional exhaustion and depersonalization. Longitudinal evidence showed that moral distress predicted emotional exhaustion (β = 0.38; p < 0.008) and depersonalization (β = 0.34; p < 0.001). Ethical climate, organizational support, work environment, moral resilience, and psychological capital also influenced these associations. The findings indicate that moral distress is consistently associated with poorer mental health among healthcare professionals. Mitigation strategies should strengthen ethical climate, organizational and leadership support, and work environments that facilitate appropriate professional decision-making.]]>
Copyrights © 2026
