Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.

This article reviews the literature on mental health of volunteers after working in disasters. When mobilized they often are a community's major source for rescue and recovery. PsychINFO, PubMED, and Web of Science were searched for relevant articles published until October 2009. Of 448 articles screened, only 9 articles fulfilled our inclusion criteria. They examined the aftermath of earthquakes (4 articles), terrorist bombings (1), explosions (1), aviation disasters (1), tsunami (1), and a bus accident (1).Findings showed that, compared with professional workers, volunteers tend to have higher complaint levels. The following factors were found to contribute to mental health complaints of volunteers: Identification with victims as a friend, severity of exposure to gruesome events during disaster work, anxiety sensitivity, and lack of postdisaster social support. The review reveals the need for more research regarding predictors of stress in volunteers.

This study aims at investigating the nature of resilience and stress experience of health care workers during the COVID-19 pandemic. Thirteen healthcare workers from Italian and Austrian hospitals specifically dealing with COVID-19 patients during the first phase of the pandemic were interviewed. Data was analysed using grounded theory methodology. Psychosocial effects on stress experience, stressors and resilience factors were identified. We generated three hypotheses. Hypothesis one is that moral distress and moral injury are main stressors experienced by healthcare workers. Hypothesis two states that organisational resilience plays an important part in how healthcare workers experience the crisis. Organisational justice and decentralized decision making are essential elements of staff wellbeing. Hypothesis three refers to effective psychosocial support: Basic on scene psychosocial support based on the Hobfoll principles given by trusted and well-known mental health professionals and peers in an integrated approach works best during the pandemic.

During disasters, aid organizations often respond using the resources of local volunteer members from the affected population who are not only inexperienced, but who additionally take on some of the more psychologically and physically difficult tasks in order to provide support for their community. Although not much empirical evidence exists to justify the claim, it is thought that preparation, training, and organizational support limit (or reduce) a volunteer's risk of developing later psychopathology. In this study, we examined the effects of preparation, training, and organizational support and assigned tasks on the mental health of 506 Indonesian Red Cross volunteers who participated in the response to a massive earthquake in Yogyakarta, Indonesia, in 2006. Controlling for exposure level, the volunteers were assessed for post-traumatic stress disorder (PTSD), anxiety, depression, and subjective health complaints (SHCs) 6, 12, and 18 months post-disaster. Results showed high levels of PTSD and SHCs up to 18 months post-disaster, while anxiety and depression levels remained in the normal range. Higher levels of exposure as well as certain tasks (e.g., provision of psychosocial support to beneficiaries, handling administration, or handing out food aid) made the volunteers more vulnerable. Sense of safety, expressed general need for support at 6 months, and a lack of perceived support from team leaders and the organization were also related to greater psychopathology at 18 months. The results highlight the importance of studying organizational factors. By incorporating these results into future volunteer management programs the negative effects of disaster work on volunteers can be ameliorated.

This study aims at investigating the nature of resilience and stress experience of health care workers during the COVID-19 pandemic. Thirteen healthcare workers from Italian and Austrian hospitals specifically dealing with COVID-19 patients during the first phase of the pandemic were interviewed. Data was analysed using grounded theory methodology. Psychosocial effects on stress experience, stressors and resilience factors were identified. We generated three hypotheses. Hypothesis one is that moral distress and moral injury are main stressors experienced by healthcare workers. Hypothesis two states that organisational resilience plays an important part in how healthcare workers experience the crisis. Organisational justice and decentralized decision making are essential elements of staff wellbeing. Hypothesis three refers to effective psychosocial support: Basic on scene psychosocial support based on the Hobfoll principles given by trusted and well-known mental health professionals and peers in an integrated approach works best during the pandemic.