Moral injury in health-care workers during COVID-19 pandemic.

Abstract

The COVID-19 pandemic forces frontline health-care workers to make difficult medical decisions that may result in moral injury. Understanding the extent to which physicians, nurses, and other health-care workers experience moral injury while working in a pandemic is of critical importance to establish preventative measures and trauma-informed treatment. A national sample of health-care workers (n ϭ 109) participated in the study. The results of a multiple regression analysis indicated secondary traumatic stress was significantly associated with moral injury. Contrary to existing literature, the role of burnout and compassion fatigue in this study was nonsignificant. Mental health professionals may reduce treatment barriers by offering flexible sessions, nontraditional hours, and short-term interventions through tele-mental health platforms to support health-care workers experiencing trauma symptoms.

Morally Distressing Experiences, Moral Injury, and Burnout in Florida Healthcare Providers during the COVID-19 Pandemic

“…As hypothesized and similar to previous findings [ 21 ], we found that MI was related to burnout. We also found that MI was associated with higher levels of psychiatric symptoms including depression, anxiety, and PTSD, a finding that is consistent with prior research focused on HCPs [ 3 , 15 ] and military samples [ 42 ].…”

“…Two publications looked at the same sample of 838 healthcare workers from Maryland and found that MI remained stable over time, was associated with sleep disturbance, and was mitigated by a supportive workplace [ 20 ]. A more recent study conducted on 109 healthcare workers recruited online through personal contacts and professional listservs focused on predicting MI from subscales of a measure of professional quality of life [ 21 ]. They found that compassion satisfaction, burnout, and secondary traumatic stress were correlated with MI and that secondary traumatic stress was the only significant predictor when all were entered into multiple regression analysis.…”

A longitudinal analysis of the role of potentially morally injurious events on COVID-19-related psychosocial functioning among healthcare providers

“…While research is still limited, the mental health consequences of healthcare providers' exposure to PMIEs and moral distress in the context of the COVID-19 pandemic are beginning to be investigated. Several cross-sectional studies with samples of individuals from different countries (China, Spain, and the United States [US]), have shown a relationship between exposure to PMIEs and greater risk for anxiety, depression, posttraumatic stress disorder (PTSD), burnout, sleep difficulties, and suicidal ideation and self-directed violence [13][14][15].…”

“My problems aren't severe enough to seek help”: Stress levels and use of mental health supports by Canadian hospital employees during the COVID-19 pandemic

“…Stressors specific to the COVID-19 pandemic include high rates of illness ( 1 ) and deaths among healthcare workers ( 2 ) ; exhaustion, burnout, concerns about personal safety, family infection, patient mortality ( [2] , [3] , [4] , [5] ) ; community stigma ( 6 ) ; lack of Personal Protective Equipment (PPE), organizational preparedness ( 7 ) ; experiences of moral injury ( 8 ) ; and feelings of powerlessness to help patients ( 9 ) . A meta-analysis of 50 studies on the mental and physical health impacts of COVID-19 identified high levels of stress (33% of the sample), anxiety (24%), psychological distress (41%), traumatic symptoms (13%), poor sleep quality (43%), and insomnia (37%) in healthcare workers ( 10 ) .…”