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Impacts of morally distressing experiences on the mental health of Canadian health care workers during the COVID-19 pandemic.
Plouffe, Rachel A; Nazarov, Anthony; Forchuk, Callista A; Gargala, Dominic; Deda, Erisa; Le, Tri; Bourret-Gheysen, Jesse; Jackson, Brittni; Soares, Vanessa; Hosseiny, Fardous; Smith, Patrick; Roth, Maya; MacDougall, Arlene G; Marlborough, Michelle; Jetly, Rakesh; Heber, Alexandra; Albuquerque, Joy; Lanius, Ruth; Balderson, Ken; Dupuis, Gabrielle; Mehta, Viraj; Richardson, J Don.
  • Plouffe RA; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Nazarov A; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Forchuk CA; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Gargala D; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Deda E; Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
  • Le T; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Bourret-Gheysen J; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Jackson B; St. Joseph's Operational Stress Injury Clinic, Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
  • Soares V; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Hosseiny F; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Smith P; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • Roth M; The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Ontario, Canada.
  • MacDougall AG; Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, Ontario, Canada.
  • Marlborough M; Institute of Mental Health Research at The Royal, University of Ottawa, Ottawa, Ontario, Canada.
  • Jetly R; Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, Ontario, Canada.
  • Heber A; Institute of Mental Health Research at The Royal, University of Ottawa, Ottawa, Ontario, Canada.
  • Albuquerque J; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Lanius R; St. Joseph's Operational Stress Injury Clinic, Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
  • Balderson K; Yeates School of Graduate Studies, Ryerson University, Toronto, Ontario, Canada.
  • Dupuis G; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Mehta V; Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Richardson JD; St. Joseph's Health Care London and Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.
Eur J Psychotraumatol ; 12(1): 1984667, 2021.
Article in English | MEDLINE | ID: covidwho-1510837
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ABSTRACT

Background:

Research is urgently needed to understand health care workers' (HCWs') experiences of moral-ethical dilemmas encountered throughout the COVID-19 pandemic, and their associations with organizational perceptions and personal well-being. This research is important to prevent long-term moral and psychological distress and to ensure that workers can optimally provide health services.

Objective:

Evaluate associations between workplace experiences during COVID-19, moral distress, and the psychological well-being of Canadian HCWs.

Method:

A total of 1362 French- and English-speaking Canadian HCWs employed during the COVID-19 pandemic were recruited to participate in an online survey. Participants completed measures reflecting moral distress, perceptions of organizational response to the pandemic, burnout, and symptoms of psychological disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD).

Results:

Structural equation modelling showed that when organizational predictors were considered together, resource adequacy, positive work life impact, and ethical work environment negatively predicted severity of moral distress, whereas COVID-19 risk perception positively predicted severity of moral distress. Moral distress also significantly and positively predicted symptoms of depression, anxiety, PTSD, and burnout.

Conclusions:

Our findings highlight an urgent need for HCW organizations to implement strategies designed to prevent long-term moral and psychological distress within the workplace. Ensuring availability of adequate resources, reducing HCW risk of contracting COVID-19, providing organizational support regarding individual priorities, and upholding ethical considerations are crucial to reducing severity of moral distress in HCWs.
RESUMEN
Antecedentes Se necesita con urgencia investigaciones para comprender las experiencias de los dilemas éticos y morales que los trabajadores de la salud encontraron durante la pandemia de la COVID-19 y su asociación con las percepciones de la organización y el bienestar personal. Esta investigación es importante para prevenir la angustia moral y psicológica a largo plazo y para asegurar que los trabajadores de la salud puedan proveer de manera óptima los servicios de salud.

Objetivo:

Evaluar la asociación entre las experiencias en el lugar de trabajo durante la COVID-19, la angustia moral y el bienestar psicológico de los trabajadores de salud canadienses.

Métodos:

Se reclutó a un total de 1362 trabajadores de salud canadienses, que hablaban francés e inglés y que fueron contratados durante la pandemia de la COVID-19, para participar en un cuestionario en línea. Los participantes completaron mediciones que reflejaban la angustia moral, la percepción de la respuesta de la organización a la pandemia, el burnout y los síntomas de trastornos psicológicos, que incluían a la depresión, a la ansiedad y al trastorno de estrés postraumático (TEPT).

Resultados:

El modelo de ecuaciones estructurales mostró que cuando los predictores de la organización se consideraban en conjunto ­ los recursos adecuados, el impacto positivo en la vida laboral y un ambiente de trabajo ético ­, predijeron negativamente la gravedad de la angustia moral, mientras que la percepción del riesgo de contraer la COVID-19 predijo positivamente la gravedad de la angustia moral. La angustia moral también predijo de manera significativa y positiva los síntomas de la depresión, la ansiedad, el TEPT y el burnout.

Conclusiones:

Nuestros hallazgos resaltan la urgente necesidad de que las organizaciones de trabajadores de salud implementen estrategias diseñadas para prevenir la angustia moral y psicológica a largo plazo en el lugar de trabajo. El asegurar la disponibilidad de los recursos adecuados, el reducir el riesgo de que los trabajadores de salud contraigan la COVID-19, el proveer un soporte organizacional adecuado según las prioridades individuales y el respetar las consideraciones éticas son fundamentales para reducir la gravedad de la angustia moral en los trabajadores de salud.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / Health Personnel / Workplace / Psychological Distress / COVID-19 / Morals Type of study: Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur J Psychotraumatol Year: 2021 Document Type: Article Affiliation country: 20008198.2021.1984667

Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / Health Personnel / Workplace / Psychological Distress / COVID-19 / Morals Type of study: Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur J Psychotraumatol Year: 2021 Document Type: Article Affiliation country: 20008198.2021.1984667