Moral injury in frontline workers of the COVID-19 pandemic and predicting factors
Summary
The spreading of the COVID-19 virus in 2020 led to overloaded hospitals and frontline workers in hospitals were confronted with a lack of resources and inadequate treatments. As a result, patients could not be provided with the best care and frontline workers were faced with moral dilemmas. Moral injury could be developed and this characterised by: (1) betrayal of what is right, (2) either inflicted by oneself or a person of authority and (3) in a high stakes situation. There is an overlap between symptoms of moral injury and Post Traumatic Stress Disorder (PTSD), however PTSD does not completely account for the morally injurious part of trauma. This research aims to gain more insight in moral injury and frontline workers and potential predicting factors. A questionnaire was designed to measure symptoms of moral injury, potential morally injurious events (PMIE’s), PTSD symptoms, negative feelings afterwards, event vividness and the centrality of event. The results show that frontline workers experience more PMIE’s related to working at the COVID-19 department and PTSD symptoms than the control group. There was no significant difference found between the groups for moral injury symptoms. This could be due to a supportive work environment or the operalization of moral injury. In addition, the results show that symptoms of moral injury were predicted by negative feelings afterwards, event vividness and the centrality of event. Lastly, an in-depth interview was held to examine the psychological burden of frontline workers. These results suggest that frontline workers experience moral dilemmas and psychological complaints. More research on moral injury and frontline workers is needed, so psychological problems during a crisis can be prevented and treated.