Predict, prevent and manage moral injuries in Canadian frontline healthcare workers and leaders facing the COVID-19 pandemic: Protocol of a mixed methods study

Gilbert-Ouimet, Mahée; Harsini, Azita Zahiri; Biron, Caroline; Langlois, Lyse; Ménard, Caroline; Lebel, Manon; Pelletier, Jérôme; Duchaine, Caroline; Beaulieu, Marianne; Truchon, Michel

doi:10.1016/j.ssmmh.2022.100124

Cited by 5 publications

(2 citation statements)

References 115 publications

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“…In study 2, Betrayal also correlated most strongly with anger, depression and PTSD symptoms, and had the strongest negative correlation with general sense of trust and presence of meaning. Conceptually, the betrayal aspect of moral injury and negative psychosocial safety are very similar, and research suggests that poor psychosocial safety climate may be a predictor of developing moral injury in occupational settings (Gilbert-Ouimet et al, 2022). Psychometrically, our study supported the distinctiveness of the Betrayal factor through its lower correlation with other factors and differential relationship to external variables.…”

Section: Differential Relationships and Theoretical Considerationssupporting

confidence: 63%

The Occupational Moral Injury Scale (OMIS) - Development and Validation in Frontline Health and First Responder Workers

Thomas¹,

Bizumić²,

Quinn³

2023

Preprint

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Moral Injury is an emerging construct that has been primarily examined in military groups but is increasingly expanding to a broader range of non-military occupational settings. A key barrier to this research on moral injury in broader occupational groups has been the lack of valid and reliable measures specifically developed for non-military settings. The current paper addresses this gap by developing the Occupational Moral Injury Scale (OMIS), a measure designed to capture both morally injurious events (MIEs) and primary markers of moral injury (guilt, shame, anger, loss of trust, existential conflict) in any occupational setting, without the need for modification. A combination of Confirmatory Factor Analyses (CFA) and Item Response Theory (IRT) analyses were used in scale development and refinement. Drawing upon a sample of 1454 frontline health and first responder workers across two studies, factor analytic results revealed an expected bifactor structure of five primary factors capturing exposure to morally injurious events (MIEs; Commission with Agency, Commission under Duress, Act of Omission, Witnessing, Betrayal) and a general factor of moral injury. Subscales demonstrated excellent internal consistency, and when compared to theoretically relevant constructs OMIS scores demonstrated strong convergent and divergent validity. Differential validity was also observed among the OMIS subscales. The OMIS provides a psychometrically validated tool for assessing moral injury risk in any occupational setting. The OMIS will help facilitate further research and understanding of how moral injury presents in high-risk occupational settings beyond the military and allow for direct comparison between these groups for the first time.

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Section: Differential Relationships and Theoretical Considerationssupporting

confidence: 63%

The Occupational Moral Injury Scale (OMIS) - Development and Validation in Frontline Health and First Responder Workers

Thomas¹,

Bizumić²,

Quinn³

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In Study 2, betrayal also correlated most strongly with anger, depression, and PTSD symptoms, and had the strongest negative correlation with a general sense of trust and presence of meaning. Conceptually, the betrayal aspect of moral injury and negative psychosocial safety climate are very similar, and research suggests that poor psychosocial safety climate may be a predictor of developing moral injury in occupational settings (Gilbert-Ouimet et al, 2022). Psychometrically, our study supported the distinctiveness of the betrayal factor through its lower correlation with other factors and differential relationship to external variables.…”

Section: Discussionmentioning

confidence: 99%

The Occupational Moral Injury Scale: Development and validation in frontline health and first responder workers.

Thomas,

Bizumic,

Quinn

2023

Traumatology

View full text Add to dashboard Cite

Moral injury is an emerging construct that has been primarily examined in military groups but is increasingly expanding to a broader range of nonmilitary occupational settings. A key barrier to this research on moral injury in broader occupational groups has been the lack of valid and reliable measures specifically developed for nonmilitary settings. The current article addresses this gap by developing the Occupational Moral Injury Scale (OMIS), a measure designed to capture both morally injurious events (MIEs) and primary markers of moral injury (guilt, shame, anger, loss of trust, existential conflict) in any occupational setting, without the need for modification. A combination of confirmatory factor analyses and item response theory analyses was used in scale development and refinement. Drawing upon a sample of 1,454 primarily frontline health and first responder workers across two studies, factor analytic results revealed an expected bifactor structure of five primary factors capturing exposure to MIEs (commission with agency, commission under duress, act of omission, witnessing, betrayal) and a general factor of moral injury. Subscales demonstrated excellent internal consistency, and when compared to theoretically relevant constructs OMIS scores demonstrated strong convergent and divergent validity. Differential validity was also observed among the OMIS subscales. The OMIS provides a psychometrically validated tool for assessing moral injury risk in any occupational setting. The OMIS will help facilitate further research and understanding of how moral injury presents in high-risk occupational settings beyond the military and allow for direct comparison between these groups for the first time.

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Self-compassion, burnout, and biomarkers in a sample of healthcare workers during the COVID-19 pandemic: a cross-sectional correlational study

Bégin,

Gilbert-Ouimet,

Truchon

2024

Discov Psychol

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Background Burnout among healthcare professionals is a serious problem with multiple consequences for the individuals and organizations affected. Thus, accessible and effective interventions are still needed to prevent and attenuate burnout. Self-compassion has recently been well supported in preventing and reducing burnout in various professions. Current research also demonstrated protective associations between self-compassion and well-being and/or psychological health indicators. Few studies are available on this topic during the COVID-19 pandemic or on healthcare workers from Quebec or Canada. Moreover, only a limited number of studies have looked at the associations of self-compassion with physiological variables. This cross-sectionnal correlational study attempts to evaluate the association between self-compassion and burnout, among healthcare workers from Quebec (Canada) during the COVID-19 pandemic (n = 416 participants). Associations between their respective components are also tested. A secondary objective is to evaluate if self-compassion is also associated with a set of 38 biomarkers of inflammation (n = 83 participants), potentially associated with the physiological stress response according to the literature. Participants meeting eligibility criteria (e.g.: residing in the province of Quebec, being 18 years of age or older, speaking French, and having been involved in providing care to COVID-19 patients) were recruited online. Participants completed the Occupational Health and Well-being Questionnaire, and some participated in a blood sample collection protocol. Results Results showed significant negative associations between self-compassion, exhaustion, and depersonalization, and a significant positive correlation with professional efficacy. Some self-compassion subscales (mindfulness, self-judgment, isolation, overidentification) were significantly negatively associated with certain biomarkers, even after controlling for confounding variables. Conclusions This study adds to the existing literature by supporting the association of self-compassion with burnout, and reveals associations between self-compassion and physiological biomarkers related to the stress response. Future research directions are discussed.

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Predict, prevent and manage moral injuries in Canadian frontline healthcare workers and leaders facing the COVID-19 pandemic: Protocol of a mixed methods study

Cited by 5 publications

References 115 publications

The Occupational Moral Injury Scale (OMIS) - Development and Validation in Frontline Health and First Responder Workers

The Occupational Moral Injury Scale (OMIS) - Development and Validation in Frontline Health and First Responder Workers

The Occupational Moral Injury Scale: Development and validation in frontline health and first responder workers.

Self-compassion, burnout, and biomarkers in a sample of healthcare workers during the COVID-19 pandemic: a cross-sectional correlational study

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