COVID-19 has united patients and providers against institutional betrayal in health care: A battle to be heard, believed, and protected.

Klest, Bridget; Smith, Carly; May, Collin; McCall-Hosenfeld, Jennifer S.; Tamaian, Andreea

doi:10.1037/tra0000855

Cited by 20 publications

(19 citation statements)

References 8 publications

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“…In addition, it is known to exacerbate various psychopathological reactions to adversity and trauma, such as anxiety, depression, and posttraumatic stress disorder (33,34). In the context of the COVID-19 crisis, the subject of institutional betrayal is now beginning to be discussed in regards to medical systems, both because of a lack of adequate provision of care for patients as well as the failure to provide sufficient personal protective equipment to health care staff (35,36). In the current project, perceived institutional betrayal refers to people's lack of trust in the local government and healthcare institutions to protect against the virus (i.e., the level to which participants felt that these institutions took inadequate action to protect personal and public health and wellbeing).…”

Section: Introductionmentioning

confidence: 99%

Negative Affect, Fatalism, and Perceived Institutional Betrayal in Times of the Coronavirus Pandemic: A Cross-Cultural Investigation of Control Beliefs

et al. 2020

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Background: A growing number of studies report that the COVID-19 pandemic has resulted in diverse aversive psychological reactions and created a global mental health crisis. However, the specific mechanisms underlying the negative emotional reactions as well as the differences between countries are only beginning to be explored. The present study examined the association of COVID-19-related fear and negative affect in Israel and Switzerland. The mediating roles of three control beliefs were explored, namely, fatalism, locus of control, and perceived institutional betrayal. Method: General population samples of 595 Swiss and 639 Israeli participants were recruited and completed an online self-report survey. Moderated Mediation using multigroup path analysis models for the two samples were conducted and compared using AMOS. Results: The multigroup path model had excellent fit for both samples. The different paths were moderated by country affiliation. Higher levels of COVID-19-related fear were associated with negative affect to an equal extent in both samples. COVID-19-related fear was associated with higher reports of institutional betrayal and a lower locus of control in both samples. Higher COVID-19-related fear was associated with lower fatalism in the Swiss sample only. In both samples, institutional betrayal mediated the association between COVID-19-related fear and negative affect, however, locus of control was a mediator in the Israeli sample only. Conclusion: The current results suggest that the reaction of the government was of crucial importance with regard to the emotional state of the two populations. Interestingly, while in the context of adversity fatalism is generally considered a risk factor for mental health, during the time of the pandemic it seems to have had protective qualities among the Swiss population. Interventions that strengthen the personal locus of control have the potential to mitigate the negative affect in Israel but not in Switzerland. Despite the fact that COVID-19 is a global phenomenon, prevention and intervention strategies should be adjusted to local contexts.

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Section: Introductionmentioning

confidence: 99%

Negative Affect, Fatalism, and Perceived Institutional Betrayal in Times of the Coronavirus Pandemic: A Cross-Cultural Investigation of Control Beliefs

et al. 2020

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“…11,17 Betrayal likely intensifies the stress of providing care with increased negative effects on well-being such as sadness, depression, anger, and burnout. 7 Coping with the stress is disrupted, which could impact the professional commitment. Likewise, healthcare professionals who experience institutional betrayal might even consider leaving the profession altogether.…”

Section: Attributes Of the Phenomenonmentioning

confidence: 99%

“…6 Institutional betrayal during the COVID-19 pandemic has been suggested as an issue for those who feel trust in their employer was violated by insufficient personnel, safety precautions, and resources, particularly in care of the most vulnerable such as nursing home residents and patients with disabilities. 7 Betrayal has also been used to describe the cultivation of a negative work environment. This could stem from lack of fulfillment of expectations.…”

Section: Definitions and Use Of The Conceptmentioning

confidence: 99%

mentioning

confidence: 99%

“…Failure to meet the needs of health and safety and to respect or acknowledge the risk nurses take to care for patients sick with a novel communicable virus could represent an important example of moral health hazards related to betrayal of trust. 7 The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing as a specific type of betrayal. This concept can be applied as a distinct environmental and cultural factor in nurse well-being and can promote conceptual clarity for use in research regarding ethical culture for nursing practice.…”

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confidence: 99%

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Institutional betrayal in nursing: A concept analysis

Brewer

2021

Nurs Ethics

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Background: Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal. Research aim: The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal. Design: This analysis uses the method developed by Walker and Avant. Research context: Studies were reviewed using health literature databases with no date restrictions. Ethical considerations: Analysis was conducted using established guidelines for ethical research. Findings: Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic. Discussion: A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept. Conclusion: In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.

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Understanding the role of COVID‐19–related workplace stress and institutional betrayal on mental health in nurses: Some heroes wear scrubs

Beck

Majeed

Brown

et al. 2023

Journal of Traumatic Stress

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This study examined the association of three specific COVID‐19–related workplace stressors (percentage of nursing work with COVID‐positive [COVID+] patients, number of COVID‐19–related patient deaths witnessed, and living separately from family for safety) and their associations with posttraumatic stress symptoms (PTSS) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among 391 nurses (93.6% White, 93.4% utilize she/her pronouns). Cross‐sectional data were collected via an online survey. Institutional betrayal (i.e., the perception that an institution failed to protect a member who depends on and trusts it) was examined as a moderator of these associations. Although institutional betrayal was not a significant moderator in the three individual models, it held small‐to‐medium–sized positive main effects with PTSS and symptoms of GAD and MDD in both the individual and combined models. In the individual models, the percentage of nursing work with COVID+ patients was significantly positively associated with all three mental health conditions, f2 = .019–.195, whereas it only showed a significant effect with PTSS in the combined model, f2 = .138. Living separately from family was significantly positively associated with PTSS and MDD symptoms in both the individual, f2 = .037 and .015, respectively, and combined models, f2 = .025 and .013, respectively. Number of patient deaths held a significant positive association with PTSS alone, f2 = .022, in the individual model only. The findings are discussed in light of ways in which health care settings can better support and prioritize mental health among nursing staff.

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COVID-19 has united patients and providers against institutional betrayal in health care: A battle to be heard, believed, and protected.

Cited by 20 publications

References 8 publications

Negative Affect, Fatalism, and Perceived Institutional Betrayal in Times of the Coronavirus Pandemic: A Cross-Cultural Investigation of Control Beliefs

Negative Affect, Fatalism, and Perceived Institutional Betrayal in Times of the Coronavirus Pandemic: A Cross-Cultural Investigation of Control Beliefs

Institutional betrayal in nursing: A concept analysis

Understanding the role of COVID‐19–related workplace stress and institutional betrayal on mental health in nurses: Some heroes wear scrubs

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