Impacts of Morally Distressing Experiences on the Mental Health of Canadian Health Care Workers During the COVID-19 Pandemic

Plouffe, Rachel A.; Nazarov, Anthony; Forchuk, Callista; Gargala, Dominic; Deda, Erisa; Le, Tri; Bourret-Gheysen, Jesse; Jackson, Brittni; Soares, Vanessa Ferry de Oliveira; Hosseiny, Fardous; Smith, Patrick; Roth, Maya; MacDougall, Arlene; Marlborough, Michelle; Jetly, Rakesh; Heber, Alexandra; Albuquerque, Joy; Lanius, Ruth A.; Balderson, Ken; Dupuis, Gabrielle; Mehta, Viraj; Richardson, J. Don

doi:10.1101/2021.04.06.21254800

Cited by 6 publications

(26 citation statements)

References 44 publications

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“…2021; Plouffe et al . 2021 ), few have been able to capture the trends in moral distress beyond a single time point (Hines et al . 2021 ; Kok et al .…”

Section: Discussionmentioning

confidence: 99%

“… 2021 ), Canada (Plouffe et al . 2021 ) Australia, Italy (Kreh et al . 2021 ), and United Kingdom (Petrella et al .…”

Section: Introductionmentioning

confidence: 99%

“…2021), with few researchers expanding to the providers affected outside of the hospital walls (Plouffe et al . 2021 ; ffrench‐O'Carroll 2021; Petrella et al . 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…These findings have persisted in recent studies including moral distress as a predictor of depression, anxiety, and PTSD (Plouffe et al . 2021 ). The changes in work design due to lack of resources, personnel, or protocols may increase the likelihood of moral distress and its relationship with mental health strain over time.…”

Section: Introductionmentioning

confidence: 99%

“… 2021 ; Plouffe et al . 2021 ). The continuous rise in patient cases and lack of effective treatment may increase the symptoms related to exhaustion, depersonalization, and reduced sense of personal accomplishment.…”

Section: Introductionmentioning

confidence: 99%

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Chronicling moral distress among healthcare providers during the COVID‐19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours

Wilson

Metwally

Heavner

et al. 2021

Int J Mental Health Nurs

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The COVID‐19 pandemic has presented many novel situations that have amplified the presence of moral distress in healthcare. With limited resources to protect themselves against the virus and strict safety regulations that alter the way they work, healthcare providers have felt forced to engage in work behaviours that conflicted with their professional and personal sense of right and wrong. Although many providers have experienced moral distress while being physically in the workplace, others suffered while at home. Some healthcare providers worked in facilities that were unable to open during the pandemic due to restrictions, which could contribute to a sense of powerlessness and guilt. The current study assessed whether the ability to see patients each week impacted the relationship between an employee's moral distress and their mental health strain, burnout, and maladaptive coping. A total of 378 healthcare providers responded to weekly surveys over the course of 7 months (April 2020–December 2020). Hierarchical linear modeling techniques were used to examine the study variables over time. Results showed that moral distress predicted an individual's mental health strain and burnout, even after controlling for the prior week. However, moral distress was not a significant predictor of maladaptive coping. Interestingly, there was not a significant difference between the average ratings of moral distress between those who were able, and those who were not able to see patients, meaning that both groups experienced symptoms of moral distress. However, cross‐level moderation results indicated that the ability to see patients magnified the relationships between moral distress and mental health strain and burnout over time. Implications of the results and recommendations for how moral distress should be addressed among healthcare providers are discussed.

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“…2021; Plouffe et al . 2021 ), few have been able to capture the trends in moral distress beyond a single time point (Hines et al . 2021 ; Kok et al .…”

Section: Discussionmentioning

confidence: 99%

“… 2021 ), Canada (Plouffe et al . 2021 ) Australia, Italy (Kreh et al . 2021 ), and United Kingdom (Petrella et al .…”

Section: Introductionmentioning

confidence: 99%

“…2021), with few researchers expanding to the providers affected outside of the hospital walls (Plouffe et al . 2021 ; ffrench‐O'Carroll 2021; Petrella et al . 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chronicling moral distress among healthcare providers during the COVID‐19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours

Wilson

Metwally

Heavner

et al. 2021

Int J Mental Health Nurs

View full text Add to dashboard Cite

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Moral distress among critical care nurses before and during the COVID-19 pandemic: A systematic review

Beheshtaeen,

Torabizadeh,

Khaki

et al. 2023

Nurs Ethics

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Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding care provided to critically ill patients in critical care units. The ongoing COVID-19 pandemic has introduced new ethical challenges and changes in clinical practice, further exacerbating the experience of moral distress among these nurses. This systematic review compares the factors influencing moral distress among critical care nurses before and during the COVID-19 pandemic to gain a comprehensive understanding of the impact of the pandemic on moral distress. For this systematic review, PubMed, Scopus, ProQuest, Web of Science, medRxiv, bioRxiv, Embase, and Google Scholar were all utilized in the search. The search covered articles published from 2012 to December 2022, encompassing a 10-year timeframe to capture relevant research on moral distress among critical care nurses. In total, 52 articles were included in this systematic review. The findings indicate that personal, caring-related, and organizational factors can influence nurses' moral distress. Before the pandemic, factors including futile and end-of-life care, conflicts with physicians, nurse performance and authority, poor teamwork, decision-making regarding treatment processes and patient care, limited human resources and equipment, medical errors, patient restraints, and nurses' age and work experience affect critical care nurses' moral distress. Similarly, during the COVID-19 pandemic, factors contributing to moral distress include futile and end-of-life care, fear of contracting and spreading COVID-19, decision-making about treatment processes, poor teamwork, and being female. This study revealed that the factors contributing to moral distress were approximately similar in both periods. Futile care and end-of-life issues were critical care nurses' primary causes of moral distress. Implementing prevention strategies and reducing these underlying factors could decrease this major issue and improve the quality of care.

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Faculty-Wide Peer-Support Program During the COVID-19 Pandemic: Design and Preliminary Results

Liu¹,

Lum²,

Foxcroft³

et al. 2023

JMIR Form Res

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Background Physicians experience higher rates of burnout relative to the general population. Concerns of confidentiality, stigma, and professional identities as health care providers act as barriers to seeking and receiving appropriate support. In the context of the COVID-19 pandemic, factors that contribute to burnout and barriers to seeking support have been amplified, elevating the overall risks of mental distress and burnout for physicians. Objective This paper aimed to describe the rapid development and implementation of a peer support program within a health care organization located in London, Ontario, Canada. Methods A peer support program leveraging existing infrastructures within the health care organization was developed and launched in April 2020. The “Peers for Peers” program drew from the work of Shapiro and Galowitz in identifying key components within hospital settings that contributed to burnout. The program design was derived from a combination of the peer support frameworks from the Airline Pilot Assistance Program and the Canadian Patient Safety Institute. Results Data gathered over 2 waves of peer leadership training and program evaluations highlighted a diversity of topics covered through the peer support program. Further, enrollment continued to increase in size and scope over the 2 waves of program deployments into 2023. Conclusions Findings suggest that the peer support program is acceptable to physicians and can be easily and feasibly implemented within a health care organization. The structured program development and implementation can be adopted by other organizations in support of emerging needs and challenges.

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Impacts of Morally Distressing Experiences on the Mental Health of Canadian Health Care Workers During the COVID-19 Pandemic

Cited by 6 publications

References 44 publications

Chronicling moral distress among healthcare providers during the COVID‐19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours

Chronicling moral distress among healthcare providers during the COVID‐19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours

Moral distress among critical care nurses before and during the COVID-19 pandemic: A systematic review

Faculty-Wide Peer-Support Program During the COVID-19 Pandemic: Design and Preliminary Results

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