The New Frontline: Exploring the Links between Moral Distress, Moral Resilience and Mental Health in Healthcare Workers Amidst the COVID-19 Pandemic

2021 ◽  
Author(s):  
Edward Spilg ◽  
Cynda Hylton Rushton ◽  
Jennifer L. Phillips ◽  
Tetyana Kendzerska ◽  
Mysa Saad ◽  
...  
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Moral Distress ◽  
Moral Resilience

scholarly journals The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Edward G. Spilg ◽  
Cynda Hylton Rushton ◽  
Jennifer L. Phillips ◽  
Tetyana Kendzerska ◽  
Mysa Saad ◽  
...  
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
Moral Distress ◽  
Protective Measure ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Moral Resilience

Abstract Background Global health crises, such as the COVID-19 pandemic, confront healthcare workers (HCW) with increased exposure to potentially morally distressing events. The pandemic has provided an opportunity to explore the links between moral distress, moral resilience, and emergence of mental health symptoms in HCWs. Methods A total of 962 Canadian healthcare workers (88.4% female, 44.6 + 12.8 years old) completed an online survey during the first COVID-19 wave in Canada (between April 3rd and September 3rd, 2020). Respondents completed a series of validated scales assessing moral distress, perceived stress, anxiety, and depression symptoms, and moral resilience. Respondents were grouped based on exposure to patients who tested positive for COVID-19. In addition to descriptive statistics and analyses of covariance, multiple linear regression was used to evaluate if moral resilience moderates the association between exposure to morally distressing events and moral distress. Factors associated with moral resilience were also assessed. Findings Respondents working with patients with COVID-19 showed significantly more severe moral distress, anxiety, and depression symptoms (F > 5.5, p < .020), and a higher proportion screened positive for mental disorders (Chi-squared > 9.1, p = .002), compared to healthcare workers who were not. Moral resilience moderated the relationship between exposure to potentially morally distressing events and moral distress (p < .001); compared to those with higher moral resilience, the subgroup with the lowest moral resilience had a steeper cross-sectional worsening in moral distress as the frequency of potentially morally distressing events increased. Moral resilience also correlated with lower stress, anxiety, and depression symptoms (r > .27, p < .001). Factors independently associated with stronger moral resilience included: being male, older age, no mental disorder diagnosis, sleeping more, and higher support from employers and colleagues (B [0.02, |-0.26|]. Interpretation Elevated moral distress and mental health symptoms in healthcare workers facing a global crisis such as the COVID-19 pandemic call for the development of interventions promoting moral resilience as a protective measure against moral adversities.

scholarly journals Moral Distress and Perceived Community Views Are Associated with Mental Health Symptoms in Frontline Health Workers during the COVID-19 Pandemic

2021 ◽  
Vol 18 (16) ◽  
pp. 8723 ◽  
Author(s):  
Natasha Smallwood ◽  
Amy Pascoe ◽  
Leila Karimi ◽  
Karen Willis
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
Moral Distress ◽  
Resource Scarcity ◽  
Health Staff ◽  
Health Concerns ◽  
Targeted Interventions ◽  
Increased Risk ◽  
Mental Health Concerns

Background: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. Methods: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations, or colleges, universities, government contacts, and national media. Results: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%), or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with increased risk of anxiety, depression, post-traumatic stress disorder, and burnout. Conversely, feeling appreciated by the community protected against these risks in healthcare workers. Conclusions: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.

scholarly journals Moral Distress and Perceived Community Views Are Associated With Mental Health Symptoms in Frontline Health Workers During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Natasha Smallwood ◽  
Amy Pascoe ◽  
Leila Karimi ◽  
Karen Willis
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
Moral Distress ◽  
Resource Scarcity ◽  
Health Staff ◽  
Health Concerns ◽  
Targeted Interventions ◽  
Increased Risk ◽  
Mental Health Concerns

Background: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. Methods: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts, and national media. Results: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%) or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with an increased risk of adverse mental health outcomes. Feeling appreciated by the community mitigated this risk in healthcare workers. Conclusions: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.

Exploring Well-being of Healthcare Workers during the COVID-19 Pandemic: A Prospective Longitudinal Study Protocol (Preprint)

2021 ◽  
Author(s):  
Jenny JW Liu ◽  
Anthony Nazarov ◽  
Rachel Alexandra Plouffe ◽  
Callista A Forchuk ◽  
Erisa Deda ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Healthcare Workers ◽  
Moral Distress ◽  
Short Form ◽  
Well Being ◽  
Initial Time ◽  
Long Form ◽  
Prospective Longitudinal

BACKGROUND Healthcare workers (HCWs) have experienced several stressors associated with the COVID-19 pandemic. Structural stressors, including extended work hours, re-deployment, and changes in organizational mandates often intersect with interpersonal and personal stressors, such as caring for those with COVID-19 infections, worrying about infection to self, family and loved ones, working despite shortages of personal protective equipment, and encountering various difficult moral-ethical dilemmas. OBJECTIVE The paper describes the protocol for a longitudinal study seeking to capture the unique experiences, challenges, and changes faced by HCWs during the COVID-19 pandemic. The study seeks to explore: (a) the impact of COVID-19 on the mental well-being of HCWs with a particular focus on moral distress, and (b) perceptions and satisfaction with delivery of care, and (c) how changes in work structure are tolerated among HCWs providing clinical services. METHODS A prospective longitudinal design is employed to assess HCWs’ experiences across domains of mental health (depression, anxiety, posttraumatic stress, and well-being), moral distress and moral reasoning, work-related changes and telehealth, organizational responses to COVID-19 concerns, and experiences with COVID-19 infections to self and to others. We recruited HCWs from across Canada through convenience snowball sampling to participate in either a short-form or long-form online survey at baseline. Respondents to the baseline survey are invited to complete a follow-up survey every three months, for a total of 18 months. RESULTS A total of 1926 participants completed baseline surveys between June 26, 2020, and December 31, 2020, and 1859 participants provided their emails for contact to participate in follow-up surveys. As of July 2021, data collection is ongoing, with participants nearing the 6 or 9-month follow-up periods depending on their initial time of self-enrollment. CONCLUSIONS The current protocol describes a study that will provide unique insights into the immediate and longitudinal impact of the COVID-19 pandemic on dimensions of mental health, moral distress, healthcare delivery, and workplace environment in HCWs. The feasibility and acceptability of implementing a short-form and long-form survey on participant engagement and data retention will also be discussed.

Healthcare-workers’ Aggressive Behavior Scale-Users--Mental Health Version

2019 ◽  
Author(s):  
José Antonio Ruiz-Hernández ◽  
María Sánchez-Muñoz ◽  
José Antonio Jiménez- Barbero ◽  
David Pina López ◽  
Inmaculada Galían-Muñoz ◽  
...  
Keyword(s):  
Mental Health ◽  
Aggressive Behavior ◽  
Healthcare Workers ◽  
Behavior Scale

scholarly journals A Longitudinal Study on the Changes in Mental Health of Healthcare Workers during the COVID-19 Pandemic

Psychiatry ◽  
2021 ◽  
pp. 1-16
Author(s):  
Lorena Cecilia López Steinmetz ◽  
Carla Romina Herrera ◽  
Shao Bing Fong ◽  
Juan Carlos Godoy
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Healthcare Workers
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