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D’Alessandro-Lowe AM, Karram M, Ritchie K, Brown A, Millman H, Sullo E, Xue Y, Pichtikova M, Schielke H, Malain A, O’Connor C, Lanius R, McCabe RE, McKinnon MC. Coping, Supports and Moral Injury: Spiritual Well-Being and Organizational Support Are Associated with Reduced Moral Injury in Canadian Healthcare Providers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6812. [PMID: 37835082 PMCID: PMC10572244 DOI: 10.3390/ijerph20196812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/08/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
Healthcare providers (HCPs) have described the onset of shame- and trust-violation-related moral injuries (MI) throughout the COVID-19 pandemic. Previous research suggests that HCPs may turn to various coping methods and supports, such as spirituality/religiosity, substance use, friends/family or organizational support, to manage workplace stress. It remains unknown, however, if similar coping methods and supports are associated with MI among this population. We explored associations between MI (including the shame and trust-violation presentations individually) and coping methods and supports. Canadian HCPs completed an online survey about their mental health and experiences during the COVID-19 pandemic, including demographic indices (e.g., sex, age, mental health history) and measures of MI, organizational support, social support, spiritual well-being, self-compassion, alcohol use, cannabis use and childhood adversity. Three hierarchical multiple linear regressions were conducted to assess the associations between coping methods/supports and (i) MI, (ii) shame-related MI and (iii) trust-violation-related MI, when controlling for age, mental health history and childhood adversity. One hundred and seventy-six (N = 176) HCPs were included in the data analysis. Spiritual well-being and organizational support were each significantly associated with reduced total MI (p's < 0.001), shame-related MI (p = 0.03 and p = 0.02, respectively) and trust-violation-related MI (p's < 0.001). Notably, comparison of the standardized beta coefficients suggests that the association between trust-violation-related MI and both spiritual well-being and organizational support was more than twice as great as the associations between these variables and shame-related MI, emphasizing the importance of these supports and the trust-violation outcomes particularly. Mental health history (p = 0.02) and self-compassion (p = 0.01) were additionally related to shame-related MI only. Our findings indicate that heightened levels of spiritual well-being and organizational support were associated with reduced MI among HCPs during the COVID-19 pandemic. Rather than placing sole responsibility for mental health outcomes on HCPs individually, organizations can instead play a significant role in mitigating MI among staff by implementing evidence-informed organizational policies and interventions and by considering how supports for spiritual well-being may be implemented into existing models of care where relevant for employees.
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Affiliation(s)
- Andrea M. D’Alessandro-Lowe
- Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L6, Canada;
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
| | - Mauda Karram
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Kim Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
| | - Andrea Brown
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Heather Millman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Emily Sullo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
| | - Yuanxin Xue
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Temetry Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mina Pichtikova
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S 1V6, Canada
| | | | - Ann Malain
- Homewood Health Centre, Guelph, ON NIE 6K9, Canada
| | | | - Ruth Lanius
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
- Lawson Health Research Institute, University of Western Ontario, London, ON N6C 2R5, Canada
| | - Randi E. McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, ON N13 6K9, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
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Kosendiak AA, Adamczak B, Bania J, Kontek S. Stress Levels, Attitude toward Vaccination and Personal Protective Equipment of Students at Wroclaw Medical University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13860. [PMID: 36360739 PMCID: PMC9655318 DOI: 10.3390/ijerph192113860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The study was conducted in March of 2021 on the students at Wroclaw Medical University from different years and faculties. Students who had mandatory physical education classes in the current year and met other eligibility criteria were enrolled. The aim of the study was to examine the impact of the pandemic on the lives of medical students. Ultimately, 660 responses to the study were included. To determine the level of stress, KPS questionnaires were used, which distinguish five types of stress. Moreover, the attitudes towards and status of vaccination were examined using PPE and declarative fettle. The findings pointed to a significantly higher level of stress in males compared to females (overall stress, 5.35 and 4.66, p = 0.0002), and increased external stress in some faculties (5.71 in dentistry, compared to overall 4.83, p = 0.009). Furthermore, medical students in their 2nd year were more stressed compared to those in their 1st year (overall stress 4.95 and 4.15, p < 0.0001). By knowing where the stress is highest, we can fight it more effectively and efficiently, by directing resources right where they are needed the most. A study about stress levels during the pandemic compared to physical activity should be developed.
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Affiliation(s)
- Aureliusz Andrzej Kosendiak
- Department of Physical Education and Sport, Wroclaw Medical University, Wojciecha z Brudzewa 12a, 51-601 Wroclaw, Poland
| | - Bartosz Adamczak
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Julia Bania
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Sylwiusz Kontek
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
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ALMasri H, Rimawi O. An evaluation of moral distress among healthcare workers during COVID-19 pandemic in Palestine. Nurs Forum 2022; 57:1220-1226. [PMID: 36352519 PMCID: PMC9877787 DOI: 10.1111/nuf.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Moral distress among healthcare workers (HCWs) is considered a serious issue in all aspects of healthcare divisions, which needs an urgent intervention. AIMS The study aims at evaluating moral distress among HCWs which will help the healthcare management and decision-makers in hospitals and health centers to act in a comprehensiveness and effective way by reinforcing moral thinking and behavior in selected coronavirus (COVID-19) quarantine centers across Palestine. METHODS Ninety-four HCWs were selected by convenience sampling method. Data were collected using revised Corley's Standard Moral Distress (MD) Scale and analyzed using SPSS software version 23. RESULTS The mean score of MD for HCWs was low (1.24 ± 0.71). The mean score of MD severity was moderate (1.4 ± 0.93). The severity and frequency of MD in HCWs had a significant reverse relationship with years of experience, number of children of worker, and duration of work with COVID-19 patients. CONCLUSION It is important to create a professional psychological support system for HCWs to decrease MD when facing moral issues.
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Affiliation(s)
- Hussein ALMasri
- Medical Imaging Department, Faculty of Health ProfessionsAl‐Quds UniversityJerusalemPalestine
| | - Omar Rimawi
- Department of Psychology, Faculty of EducationAl‐Quds UniversityJerusalemPalestine
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