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

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 O’Connor, Hugo Schielke, Ann Malain, Randi E. McCabe, Alexandra Heber, Ruth A. Lanius and Margaret C. McKinnon ()
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Kim Ritchie: Trent/Fleming School of Nursing, Trent University, Peterborough, ON K9L 0G2, Canada
Andrea M. D’Alessandro-Lowe: Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4L8, 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
Mina Pichtikova: 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
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
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
Sara Rodrigues: Atlas Institute of Veterans and Families, 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
Alexandra Heber: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada
Ruth A. Lanius: Homewood Health Centre, Guelph, ON N1E 6K9, Canada
Margaret C. McKinnon: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L9C 0E3, Canada

IJERPH, 2023, vol. 20, issue 6, 1-12

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.

Keywords: potentially morally injurious events; moral injury; healthcare providers; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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