The Hidden Crisis: Understanding Potentially Morally Injurious Events Experienced by Healthcare Providers during COVID-19 in Canada

Healthcare providers (HCPs) may be at elevated risk for moral injury due to increased exposure to potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic. Identifying PMIEs experienced during the COVID-19 pandemic is a critical first step for understanding moral injury in HCPs....

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Published in:International journal of environmental research and public health 2023-03, Vol.20 (6), p.4813
Main Authors: Ritchie, Kim, D'Alessandro-Lowe, Andrea M, Brown, Andrea, Millman, Heather, Pichtikova, Mina, Xue, Yuanxin, Altman, Maxwell, Beech, Isaac, Karram, Mauda, Hosseiny, Fardous, Rodrigues, Sara, O'Connor, Charlene, Schielke, Hugo, Malain, Ann, McCabe, Randi E, Heber, Alexandra, Lanius, Ruth A, McKinnon, Margaret C
Format: Article
Language:English
Subjects:
Aggression
Anxiety
Bullying
Canada
Canada - epidemiology
Coronaviruses
COVID-19
COVID-19 - epidemiology
Epidemics
Ethics
Health care
Health Personnel
Health risks
Humans
Injury analysis
Mental depression
Mental health
Moral injury
Morals
Pandemics
Patients
Personal protective equipment
Post traumatic stress disorder
Protective equipment
Qualitative analysis
Software
Stress Disorders, Post-Traumatic - epidemiology
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Summary:Healthcare providers (HCPs) may be at elevated risk for moral injury due to increased exposure to potentially morally injurious events (PMIEs) throughout the COVID-19 pandemic. Identifying PMIEs experienced during the COVID-19 pandemic is a critical first step for understanding moral injury in HCPs. Accordingly, the purpose of the present study was to gain a deeper understanding of the work-related PMIEs experienced by HCPs in Canada during the pandemic. Canadian HCPs completed an online survey between February and December 2021 about mental health and functioning, including demographics and the Moral Injury Outcome Scale (MIOS). We conducted a qualitative thematic analysis of PMIEs described extemporaneously by HCPs in the open-text field of the MIOS. One-hundred and twenty-four ( = 124) HCPs were included in analysis. Eight PMIE-related themes were identified, comprising patients dying alone; provision of futile care; professional opinion being ignored; witnessing patient harm; bullying, violence and divided opinions; resources and personal protective equipment; increased workload and decreased staffing; and conflicting values. Understanding broad categories of PMIES experienced by Canadian HCPs during the COVID-19 pandemic provides an opportunity to enhance cultural competency surrounding their experiences which will aid the development of targeted prevention and intervention approaches.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph20064813