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Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers

BACKGROUND: Moral injury has primarily been studied in combat veterans but might also affect healthcare workers (HCWs) due to the COVID-19 pandemic. OBJECTIVE: To compare patterns of potential moral injury (PMI) between post-9/11 military combat veterans and healthcare workers (HCWs) surveyed during...

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Autores principales: Nieuwsma, Jason A., O’Brien, Emily C., Xu, Haolin, Smigelsky, Melissa A., Meador, Keith G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8982664/
https://www.ncbi.nlm.nih.gov/pubmed/35381899
http://dx.doi.org/10.1007/s11606-022-07487-4
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author Nieuwsma, Jason A.
O’Brien, Emily C.
Xu, Haolin
Smigelsky, Melissa A.
Meador, Keith G.
author_facet Nieuwsma, Jason A.
O’Brien, Emily C.
Xu, Haolin
Smigelsky, Melissa A.
Meador, Keith G.
author_sort Nieuwsma, Jason A.
collection PubMed
description BACKGROUND: Moral injury has primarily been studied in combat veterans but might also affect healthcare workers (HCWs) due to the COVID-19 pandemic. OBJECTIVE: To compare patterns of potential moral injury (PMI) between post-9/11 military combat veterans and healthcare workers (HCWs) surveyed during the COVID-19 pandemic. DESIGN: Cross-sectional surveys of veterans (2015–2019) and HCWs (2020–2021) in the USA. PARTICIPANTS: 618 military veterans who were deployed to a combat zone after September 11, 2001, and 2099 HCWs working in healthcare during the COVID-19 pandemic. MAIN MEASURES: Other-induced PMI (disturbed by others’ immoral acts) and self-induced PMI (disturbed by having violated own morals) were the primary outcomes. Sociodemographic variables, combat/COVID-19 experience, depression, quality of life, and burnout were measured as correlates. KEY RESULTS: 46.1% of post-9/11 veterans and 50.7% of HCWs endorsed other-induced PMI, whereas 24.1% of post-9/11 veterans and 18.2% of HCWs endorsed self-induced PMI. Different types of PMI were significantly associated with gender, race, enlisted vs. officer status, and post-battle traumatic experiences among veterans and with age, race, working in a high COVID-19–risk setting, and reported COVID-19 exposure among HCWs. Endorsing either type of PMI was associated with significantly higher depressive symptoms and worse quality of life in both samples and higher burnout among HCWs. CONCLUSIONS: The potential for moral injury is relatively high among combat veterans and COVID-19 HCWs, with deleterious consequences for mental health and burnout. Demographic characteristics suggestive of less social empowerment may increase risk for moral injury. Longitudinal research among COVID-19 HCWs is needed. Moral injury prevention and intervention efforts for HCWs may benefit from consulting models used with veterans.
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spelling pubmed-89826642022-04-06 Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers Nieuwsma, Jason A. O’Brien, Emily C. Xu, Haolin Smigelsky, Melissa A. Meador, Keith G. J Gen Intern Med Original Research BACKGROUND: Moral injury has primarily been studied in combat veterans but might also affect healthcare workers (HCWs) due to the COVID-19 pandemic. OBJECTIVE: To compare patterns of potential moral injury (PMI) between post-9/11 military combat veterans and healthcare workers (HCWs) surveyed during the COVID-19 pandemic. DESIGN: Cross-sectional surveys of veterans (2015–2019) and HCWs (2020–2021) in the USA. PARTICIPANTS: 618 military veterans who were deployed to a combat zone after September 11, 2001, and 2099 HCWs working in healthcare during the COVID-19 pandemic. MAIN MEASURES: Other-induced PMI (disturbed by others’ immoral acts) and self-induced PMI (disturbed by having violated own morals) were the primary outcomes. Sociodemographic variables, combat/COVID-19 experience, depression, quality of life, and burnout were measured as correlates. KEY RESULTS: 46.1% of post-9/11 veterans and 50.7% of HCWs endorsed other-induced PMI, whereas 24.1% of post-9/11 veterans and 18.2% of HCWs endorsed self-induced PMI. Different types of PMI were significantly associated with gender, race, enlisted vs. officer status, and post-battle traumatic experiences among veterans and with age, race, working in a high COVID-19–risk setting, and reported COVID-19 exposure among HCWs. Endorsing either type of PMI was associated with significantly higher depressive symptoms and worse quality of life in both samples and higher burnout among HCWs. CONCLUSIONS: The potential for moral injury is relatively high among combat veterans and COVID-19 HCWs, with deleterious consequences for mental health and burnout. Demographic characteristics suggestive of less social empowerment may increase risk for moral injury. Longitudinal research among COVID-19 HCWs is needed. Moral injury prevention and intervention efforts for HCWs may benefit from consulting models used with veterans. Springer International Publishing 2022-04-05 2022-06 /pmc/articles/PMC8982664/ /pubmed/35381899 http://dx.doi.org/10.1007/s11606-022-07487-4 Text en © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022
spellingShingle Original Research
Nieuwsma, Jason A.
O’Brien, Emily C.
Xu, Haolin
Smigelsky, Melissa A.
Meador, Keith G.
Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title_full Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title_fullStr Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title_full_unstemmed Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title_short Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
title_sort patterns of potential moral injury in post-9/11 combat veterans and covid-19 healthcare workers
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8982664/
https://www.ncbi.nlm.nih.gov/pubmed/35381899
http://dx.doi.org/10.1007/s11606-022-07487-4
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