Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis

European journal of psychotraumatology, Год журнала: 2024, Номер 15(1)

Опубликована: Янв. 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.

Язык: Английский

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Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations

Human Resources for Health, Год журнала: 2024, Номер 22(1)

Опубликована: Янв. 25, 2024

Abstract Background Health and care workers (HCW) faced the double burden of SARS-CoV-2 pandemic: as members a society affected by public health emergency HWC who experienced fear becoming infected infecting others, stigma, violence, increased workloads, changes in scope practice, among others. To understand short long-term impacts terms COVID-19 pandemic other emergencies international concern (PHEICs) on HCW relevant interventions to address them, we designed conducted living systematic review (LSR). Methods We reviewed literature retrieved from MEDLINE—PubMed, Embase, SCOPUS, LILACS, World Organization database, ClinicalTrials.org ILO published January 2000 until December 2021. included quantitative observational studies, experimental quasi-experimental, mixed methods or qualitative studies; addressing mental, physical well-being quality life. The targeted HCW; exposures, implemented during PHEICs. assess risk bias used Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation meta-analysis was performed estimate pooled prevalence some outcomes. Results 1013 studies mainly research, cross-sectional, with medium bias/quality, at least one following: mental issue, well-being, Additionally, short- impact PHEICs review, although scarce, behavioral individual oriented, aimed improving through development interventions. A lack organizational systemic bottlenecks noted. Discussion impacted greatest toll health. are intricate complex. revealed consequences for service delivery, unplanned absenteeism, disruption occupation turnover that subvert capacity answer PHEICs, specifically challenging resilience systems.

Язык: Английский

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Policy Changes as a Context for Moral Injury Development in the Wake of Dobbs v Jackson Women's Health Organization

Obstetrics and Gynecology, Год журнала: 2022, Номер 141(1), С. 15 - 21

Опубликована: Ноя. 30, 2022

The U.S. Supreme Court’s 2022 ruling in Dobbs v Jackson Women's Health Organization held that the Constitution does not confer right to an abortion, which set into motion overhaul of reproductive health care services certain states. professionals are now operating within a rapidly changing landscape clinical practice they may experience conflict between personal and professional morals (eg, bodily autonomy, patient advocacy), uncertainty regarding allowable practices, fear prosecution loss medical license) related services. ethical dilemmas stemming from create context for exposure potentially morally injurious events, moral distress, injury (ie, functional impairment violations) among professionals. Considerations intervention approaches policy reviewed. Early identification professionals' event restricted is critical preventing intervening on injury, with implications improving functioning retention field.

Язык: Английский

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Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis

World Journal of Psychiatry, Год журнала: 2025, Номер 15(3)

Опубликована: Фев. 26, 2025

Military personnel frequently face unique psychological challenges due to high-stress environments, which increase the risk of mental health issues like anxiety and depression. Acceptance commitment therapy (ACT) has shown potential in addressing these by enhancing flexibility resilience. To systematically evaluate effectiveness ACT improving military personnel. Through a scoping review meta-analysis, we quantitatively assess impact on outcomes, guiding future research clinical practice. Relevant literature was searched from database inception June 30, 2023, across multiple databases, including PubMed, Web Science, Cochrane Library, Embase. The Joanna Briggs Institute's (JBI) guidelines were used as methodological framework. Meta-analysis performed using random-effects model, publication bias assessed through Egger's regression test Begg's funnel plot. Twenty-six studies included, highlighting application PTSD, chronic pain, anxiety, depression among meta-analysis eight demonstrated significant positive effect health, with pooled mean difference -4.99 (95%CI: -6.53 -3.45). Despite high heterogeneity (I² = 63%), sensitivity analyses confirmed robustness findings. This study underscores an effective intervention for Future should focus large-scale, multi-center RCTs further validate findings, particularly within diverse populations.

Язык: Английский

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A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions

BMC Health Services Research, Год журнала: 2024, Номер 24(1)

Опубликована: Апрель 4, 2024

Abstract Background NHS England funded 40 Mental Health and Wellbeing Hubs to support health social care staff affected by the COVID-19 pandemic. We aimed document variations in how national guidance was adapted local contexts of four North England. Methods used a modified version Price’s (2019) service mapping methodology. Service level data were inform analysis. A template from range tools, including European Mapping Schedule, reviewed Hub leads. Key included model; staffing; interventions. Data collected between March 2021 – 2022 site research assistants. Findings accuracy-checked leads, logic model developed theorise may effect change. Results goals models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, rapid access mental (in-house external). Implementation context client group with high need, waiting times at external services. predominantly staffed experienced clinicians, manage these presentations organisational working. Formulation-based psychological assessment provision direct therapy not core functions model, however all incorporated adaptations into their response contexts, such as extensive lists within services, and/or falling gaps existing provision. Finally, standalone records system seen important reassure users confidentiality. Other more nuanced variation depended on localised contexts. Conclusion This study provides map for setting up emphasising early understandings new services will integrate systems. Local regional led configuration. Whilst additional are supported available literature, further is needed determine whether should comprise essential components wellbeing moving forward. Future also comparative effectiveness components, limits permissible variation. Study registration researchregistry6303.

Язык: Английский

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‘Isolated together’: online group treatments during the COVID-19 pandemic. A systematic review

Research in Psychotherapy Psychopathology Process and Outcome, Год журнала: 2022, Номер unknown

Опубликована: Ноя. 4, 2022

Considering the emerging need to face negative impact of pandemic on mental health, social support, and access health services, it became a critical issue adapt online group settings create new interventions developing distress during this time. The aim current study is investigate main findings OPGI conducted COVID-19 from March 2020 until 2022, with particular focus on: i) therapeutic factors; ii) what kind works for whom; iii) dimensions. In accordance PRISMA guidelines, we performed systematic review scientific databases (PsychINFO, PubMed, Web Science EBSCO) searching studies published between 2022. 'Group intervention' or 'group therapy' treatment' crossed 'COVID-19' synonymous, were used as keywords. Internet based intervention was an eligibility criteria full-text screening. A total 1326 articles identified, which 24 met inclusion criteria. Among all studies, different participants orientations, data extracted supported psychological effective approach reducing increasing resources in interpersonal field. Our also showed that has led needs issues, require investigation dimensions interventions. Methodological clinical implications will be discussed through descriptive table related setting characteristics. Recommendations are made future research.

Язык: Английский

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Critical Care Providers’ Moral Distress: Frequency, Burden, and Potential Resources

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 20(1), С. 333 - 333

Опубликована: Дек. 26, 2022

Background: Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards may entail moral distress (MD). Aim: To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) further clarify whether who rely on spiritual resources differ perception of from those do not utilize these resources. Methods: A cross-sectional anonymous survey was administered using a modified version the German language Moral Distress Scale (MDS) with 2 × 12 items to assess frequency respective burden specific applying 5-point Likert scale. Explorative factor analysis performed sub-constructs regarding were identified. Job satisfaction measured visual analogue scales (VAS) four-point scale, respectively. The 15-item SpREUK questionnaire applied measure attitudes behaviours differentiate between religious persons. Data 385 German-speaking included (55% physicians, 45% nurses). Results: Conflict are similar for physicians nurses although they as more burdensome nurses. Among MDS Looking away/Resignation scores highest assistant physician residents, whereas caused looking away is often specialist without managerial position. Work inversely associated emotional exhaustion positively it. Participants’ spirituality marginally MD. best predictors both influences work satisfaction, being nurse, non-believer perception. Being participants’ ICU/ED, male gender burden. Conclusions: experienced differently different groups depending place hierarchy responsibility. As predicted exhaustion, should be avoided. Although some resources, all need individual team support cope

Язык: Английский

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Research Gaps and Recommendations to Guide Research on Assessment, Prevention, and Treatment of Moral Injury Among Healthcare Workers

Frontiers in Psychiatry, Год журнала: 2022, Номер 13

Опубликована: Апрель 15, 2022

Healthcare workers face numerous occupational stressors, including some that may challenge personal and shared morals values. This is particularly true during disasters crises such as the COVID-19 pandemic, which require critical decisions to be made with little time information often under distress situational constraints. Consequently, healthcare are at risk for moral injuries characterized by stress-related functional impacts. Although research on evaluation treatment of injury among military veterans burgeoned in recent decade, addressing other civilians remains an important gap. In this perspective piece, we identify gaps make recommendations advance future work assessment, prevention, workers. We draw empirical studies veterans, limited health professionals, our clinical experiences affected injury.

Язык: Английский

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Moving From Moral Distress to Moral Resilience Using Acceptance and Commitment Therapy

Canadian Journal of Career Development, Год журнала: 2023, Номер 22(1), С. 30 - 40

Опубликована: Янв. 20, 2023

Moral distress (MD) is a problematic experience for healthcare workers, with career engagement implications including burnout, job turnover, and turnover. Instances of MD have been increasing since the start COVID-19 pandemic, threatening greater problems system. Although range interventions explored, no evidence-based treatment has identified. Because how embedded ethical decision-making in field, it unlikely that will be eradicated; however, suggested can learned from transformed into moral resilience. Evidence indicates workers could benefit mindfulness-based emotion regulation skills, alongside values-based action strategies, to support development This article proposes applicability Acceptance Commitment Therapy (ACT) its six core skills—acceptance, cognitive defusion, mindfulness, self-as-context, values, commitment—to work practitioners as means developing resilience skills among supporting sustainability.

Язык: Английский

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“Collapsing into Darkness”: An Exploratory Qualitative Thematic Analysis of the Experience of Workplace Reintegration among Nurses with Operational Stress Injuries

International Journal of Environmental Research and Public Health, Год журнала: 2023, Номер 20(17), С. 6664 - 6664

Опубликована: Авг. 28, 2023

Nurses are engaged in an unpredictable and dynamic work environment where they exposed to events that may cause or contribute physical and/or psychological injuries. Operational stress injury (OSI) lead extended time away from nurses leaving the profession altogether. A deliberate focus on workplace reintegration phase of mental health recovery process increased retention their profession. Prior creation implementation potential solutions address reintegration, it is imperative explore experiences perceptions affected by OSI. This qualitative study aims investigate (N = 7) employed within a Canadian provincial healthcare system who have attempted after being off with OSI.Nurses were recruited via social media, unit emails, word mouth. Data collected through recorded semi-structured interviews conducted over videoconferencing. Once transcribed, data thematically analyzed using inductive approach.The resulting themes included (1) heroes zeros, (2) changing status quo, (3) connection key, (4) post-traumatic growth: advocacy altruism. Study participants indicated both nursing culture cumulation contributed need for leave absence formalized was desired assist returning work.The development, implementation, exploration innovative policies, procedures, initiatives bridge gap clinical interventions needed experiencing Further research also regarding impacts appropriate resources support injury.

Язык: Английский

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