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

Author

Listed:
  • Kim Ritchie

    (Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
    Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
    These authors share first authorship of this manuscript.)

  • Andrea M. D’Alessandro-Lowe

    (Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada
    These authors share first authorship of this manuscript.)

  • 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)

  • 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)

  • Yuanxin Xue

    (Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
    Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada)

  • Maxwell Altman

    (Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada)

  • Isaac Beech

    (Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
    Homewood Research Institute, Guelph, ON N1E 6K9, Canada)

  • Mauda Karram

    (Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada)

  • Fardous Hosseiny

    (Atlas Institute of Veterans and Families, Ottawa, ON K1Z 7K4, Canada
    Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON K1Z 7K4, Canada)

  • Sara Rodrigues

    (Atlas Institute of Veterans and Families, Ottawa, ON K1Z 7K4, Canada
    Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON K1Z 7K4, Canada)

  • Charlene O’Connor

    (Homewood Health Centre, Guelph, ON N1E 6K9, Canada)

  • Hugo Schielke

    (Homewood Health Centre, Guelph, ON N1E 6K9, Canada)

  • Ann Malain

    (Homewood Health Centre, Guelph, ON N1E 6K9, 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)

  • Alexandra Heber

    (Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
    Veteran’s Affairs Canada, Ottawa, ON K1H 1A1, Canada)

  • Ruth A. Lanius

    (Homewood Health Centre, Guelph, ON N1E 6K9, Canada
    Lawson Health Research Institute, University of Western Ontario, London, ON N6A 3K7, Canada)

  • Margaret C. McKinnon

    (Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
    Homewood Research Institute, Guelph, ON N1E 6K9, Canada
    St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada)

Abstract

Background: 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. Methods: 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. Results: One-hundred and twenty-four ( N = 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. Conclusions: 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.

Suggested Citation

  • Kim Ritchie & Andrea M. D’Alessandro-Lowe & Andrea Brown & Heather Millman & Mina Pichtikova & Yuanxin Xue & Maxwell Altman & Isaac Beech & Mauda Karram & Fardous Hosseiny & Sara Rodrigues & Charlene , 2023. "The Hidden Crisis: Understanding Potentially Morally Injurious Events Experienced by Healthcare Providers during COVID-19 in Canada," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:6:p:4813-:d:1091928
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    References listed on IDEAS

    as
    1. Priya-Lena Riedel & Alexander Kreh & Vanessa Kulcar & Angela Lieber & Barbara Juen, 2022. "A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19," IJERPH, MDPI, vol. 19(3), pages 1-20, February.
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    Cited by:

    1. Andrea M. D’Alessandro-Lowe & Mauda Karram & Kim Ritchie & Andrea Brown & Heather Millman & Emily Sullo & Yuanxin Xue & Mina Pichtikova & Hugo Schielke & Ann Malain & Charlene O’Connor & Ruth Lanius &, 2023. "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," IJERPH, MDPI, vol. 20(19), pages 1-17, September.

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