International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(3), P. 1666 - 1666
Published: Feb. 1, 2022
Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and distress (MD) as well potentially morally injurious events (PMIEs) injury (MI). These constructs offer a novel approach to understanding workplace in settings, especially demanding times COVID-19, but they so far lack clear identification causes consequences. A scoping review stressors, distress, PMIEs, MI COVID-19 was conducted using databases Web Science Core Collection PsycINFO based on articles published up October 2021. Studies were selected following inclusion criteria: (1) measurement either stress, MD, or among HCWs; (2) original research qualitative quantitative methods; (3) availability peer-reviewed article English German. The initial search revealed n = 149,394 studies from 34 EBSCOhost. Nineteen included review. Conditions representing PMIEs MD their potential outcomes contexts are presented discussed. Highlighting HCWs brings attention need conceptualizing impact any degree. Therefore, development common, theoretically founded model is desirable.
Language: Английский
Citations
183Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis
European journal of psychotraumatology, Journal Year: 2024, Volume and Issue: 15(1)
Published: Jan. 2, 2024
: During the COVID-19 pandemic, health-care workers (HCWs) may have been confronted with situations that culminate in moral injury (MI). MI is psychological distress result from perpetrating or witnessing actions violate one's codes. Literature suggests can be associated mental health problems.
Language: Английский
Citations
19‘It hurts your heart’: frontline healthcare worker experiences of moral injury during the COVID-19 pandemic
European journal of psychotraumatology, Journal Year: 2022, Volume and Issue: 13(2)
Published: Oct. 18, 2022
Background: Moral injury is defined as the strong emotional and cognitive reactions following events which clash with someone's moral code, values or expectations. During COVID-19 pandemic, increased exposure to Potentially Morally Injurious Events (PMIEs) has placed healthcare workers (HCWs) at risk of injury. Yet little known about lived experience cumulative PMIE how NHS staff respond this.Objective: We sought rectify this knowledge gap by qualitatively exploring experiences perspectives clinical frontline who responded COVID-19.Methods: recruited a diverse sample 30 HCWs from CHECK study cohort, for single time point qualitative interviews. All participants endorsed least one item on 9-item Injury Scale (MIES) [Nash et al., 2013. Psychometric evaluation scale. Military Medicine, 178(6), 646–652] six month follow up. Interviews followed semi-structured guide were analysed using reflexive thematic analysis.Results: described being routinely exposed ethical conflicts, created exacerbations pre-existing systemic issues including inadequate staffing resourcing. found that experienced range mental health symptoms primarily related perceptions institutional betrayal well feeling unable fulfil their duty care towards patients.Conclusion: These results suggest multi-facetted organisational strategy warranted prepare exposure, promote opportunities resolution associated prevent disengagement.HIGHLIGHTS Clinical have been an accumulation potentially morally injurious throughout betrayed both government leaders provide patients.HCWs significant adverse impact health, anxiety depression sleep disturbance.Most interviewed believed change within was necessary excess distress.
Language: Английский
Citations
53Potential Circumstances Associated With Moral Injury and Moral Distress in Healthcare Workers and Public Safety Personnel Across the Globe During COVID-19: A Scoping Review
Frontiers in Psychiatry, Journal Year: 2022, Volume and Issue: 13
Published: June 13, 2022
Healthcare workers (HCWs) and public safety personnel (PSP) across the globe have continued to face ethically morally challenging situations during COVID-19 pandemic that increase their risk for development of moral distress (MD) injury (MI). To date, however, global circumstances confer MD MI in these cohorts not been systematically explored, nor unique may exist countries explored. Here, we sought identify compare, globe, potentially injurious or distressful events (PMIDEs) HCWs PSP pandemic. A scoping review was conducted synthesize knowledge on PMIDEs select PSP. Six databases were searched, including MEDLINE, EMBASE, Web Science, PsychInfo, CINAHL, Global Health. total 1,412 articles retrieved, which 57 included this review. These collectively described experiences samples from 19 different countries, comprised almost exclusively HCWs. Given lack data, following results should be generalized populations without further research. Using qualitative content analysis, six themes describing associated with identified: (1) Risk contracting transmitting COVID-19; (2) Inability work frontlines; (3) Provision suboptimal care; (4) Care prioritization resource allocation; (5) Perceived support unfair treatment by organization; (6) Stigma, discrimination, abuse. a range emotions related PMIDEs, anxiety, fear, guilt, shame, burnout, anger, helplessness. Most PMIDE appeared shared globally, particularly ‘Risk COVID-19’ ‘Perceived organization.’ Articles within theme ‘Stigma, abuse’ represented smallest distribution all themes. Overall, present provides insight into encountered COVID-19. Further research is required differentiate experience HCWs, explore impact social cultural factors MI.
Language: Английский
Citations
43Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure
The American Journal of Bioethics, Journal Year: 2023, Volume and Issue: 24(12), P. 8 - 22
Published: June 22, 2023
Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of inquiry often overlook a range routine threats to professional integrity work. Using examples from our research frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between
Language: Английский
Citations
29Transferable military medical lessons from the Russo-Ukraine war
BMJ Military Health, Journal Year: 2023, Volume and Issue: unknown, P. e002435 - e002435
Published: July 3, 2023
The first year of the war in Ukraine has presented critical lessons for UK's Defence Medical Services (DMS) regarding its preparedness to support nation warfighting at scale. There are tactical, clinical, and strategic challenges that must be addressed. exposed
Language: Английский
Citations
19Toward a Dimensional Contextual Model of Moral Injury: A Scoping Review on Healthcare Workers
Current Treatment Options in Psychiatry, Journal Year: 2023, Volume and Issue: 10(3), P. 199 - 216
Published: July 4, 2023
Abstract Purpose of Review Healthcare workers (HCWs) may be exposed to potentially morally injurious events (PMIEs) while on the job and consequently experience acute, functional moral distress prolonged, impairing injury. Recent Findings We reviewed 185 articles and/or injury among HCWs. This included 91 empirical studies (approximately 50% retained articles), 68 editorials (37%), 18 reviews (10%), 8 protocol papers (4%). Themes were explored using bibliometric network analysis keyword co-citation. Empirical found evidence PMIE exposure a considerable proportion Greater severity was associated with worse mental occupational health outcomes, especially women (vs. men), younger HCWs older), nurses physicians), those who worked more hours, less experience. Programs prevent treat lack evidence. Summary Efforts maintain well-being effectiveness should consider potential impact To that end, we introduce dimensional contextual model in healthcare settings discuss recommendations for prevention treatment.
Language: Английский
Citations
19Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis
BMJ Open, Journal Year: 2024, Volume and Issue: 14(2), P. e071776 - e071776
Published: Feb. 1, 2024
Occupational moral injury and post-traumatic embitterment disorder (PTED) describe the psychological distress caused by exposure to injustice at work. This meta-analysis aims determine prevalence of occupational PTED establish whether estimates differ depending on occupation. A systematic review meta-analysis. Google Scholar, PubMed, APA PsycINFO, Web Science Core Collection, Scopus, ScienceDirect Sage Journals Online were searched in June 2020 updated November 2022. Observational studies that measured or average scores injury, any group geographical location. Two independent reviewers screened coded eligible studies. Study design, participant demographics, sampling method, location, measurement tool extracted. Risk bias was assessed using Quality Assessment Checklist for Prevalence Studies tool. Meta-analysis conducted random effects models. Results could not be combined summarised qualitatively a narrative synthesis Guidance Systematic Reviews. In total, 88 across armed forces veterans, healthcare, first responders, educators, journalists, child protection service employees, unemployed, public-sector employees mixed occupations included. included each separate based measure used ranged from 2 30. The pooled clinically relevant healthcare professionals 45%, potentially morally injurious event (PMIE) 67%. Exposure transgressions others betrayal significantly lower than civilian occupations. Pooled 26%. PMIEs, symptoms are prevalent work more likely forces. CRD42020191766.
Language: Английский
Citations
8Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies
PLoS ONE, Journal Year: 2024, Volume and Issue: 19(6), P. e0303013 - e0303013
Published: June 27, 2024
At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns own values; a phenomenon known moral distress. Similarly, there are increasing reports of experiencing long-term mental and pain, alongside internal dissonance, injury. This review examined the triggers factors injury Health Social Care Workers (HSCW) employed across range clinical settings aim understanding how mitigate effects identify potential preventative interventions.
Language: Английский
Citations
7Associations between psychosocial stressors at work and moral injury in frontline healthcare workers and leaders facing the COVID-19 pandemic in Quebec, Canada: A cross-sectional study
Journal of Psychiatric Research, Journal Year: 2022, Volume and Issue: 155, P. 269 - 278
Published: Sept. 15, 2022
Healthcare workers (HCWs) on the frontline of COVID-19 pandemic exhibit a high prevalence depression and psychological distress. Moral injury (MI) can lead to such mental health problems. MI occurs when perpetrating, failing prevent, or bearing witness acts that transgress deeply held moral beliefs expectations. Since start pandemic, psychosocial stressors at work (PSWs) might have been exacerbated, which in turn led an increased risk HCWs. However, research into associations between PSWs is lacking. Considering these are frequent most them modifiable occupational factors, they may constitute promising prevention targets. This study aims evaluate set HCWs during third wave Quebec, Canada. Furthermore, our explore potential differences urban non-urban regions. The sample this consisted 572 leaders from Quebec province. Prevalence ratios (PR) their 95% confidence intervals (CI) were modelled using robust Poisson regressions. Several covariates considered, including age, sex, gender, socio-economic indicators, lifestyle factors. Results indicated exposed 2.22-5.58 times more likely experience MI. Low ethical culture had strongest association (PR: 5.58, CI: 1.34-23.27), followed by low reward 4.43, 2.14-9.16) emotional demands 4.32, 1.89-9.88). Identifying predictors could contribute reduction problems implementation targeted interventions areas.
Language: Английский
Citations
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