Moral injury and psychosocial functioning in health care workers during the COVID-19 pandemic.

Abstract

Studies of moral injury among nonmilitary samples are scarce despite repeated calls to examine the prevalence and outcomes of moral injury among civilian frontline workers. The purpose of this study was to describe the prevalence of moral injury and to examine its association with psychosocial functioning among health care workers during the COVID-19 pandemic. We surveyed health care workers (N = 480), assessing exposure to potentially morally injurious events (PMIEs) and psychosocial functioning. Data were analyzed using latent class analysis (LCA) to explore patterns of PMIE exposure (i.e., classes) and corresponding psychosocial functioning. The <i>minimal exposure</i> class, who denied PMIE exposure, accounted for 22% of health care workers. The <i>moral injury-other</i> class included those who had witnessed PMIEs for which others were responsible and felt betrayed (26%). The <i>moral injury-self</i> class comprised those who felt they transgressed their own values in addition to witnessing others' transgressions and feeling betrayed (11%). The <i>betrayal-only</i> class included those who felt betrayed by government and community members but otherwise denied PMIE exposure (41%). Those assigned to the <i>moral injury-self</i> class were the most impaired on a psychosocial functioning composite, followed by those assigned to <i>the moral injury-other</i> and <i>betrayal-only</i> classes, and finally the <i>minimal exposure</i> class. Moral injury is prevalent and impairing for health care workers, which establishes a need for interventions with health care workers in organized care settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).