TY - JOUR
T1 - Moral injury and psychological wellbeing in UK healthcare staff
AU - Williamson, Victoria
AU - Lamb, Danielle
AU - Hotopf, Matthew
AU - Raine, Rosalind
AU - Stevelink, Sharon
AU - Wessely, Simon
AU - Docherty, Mary Jane
AU - Madan, Ira
AU - Murphy, D.
AU - Greenberg, Neil
N1 - Funding Information:
This study was part funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. Funding for NHS CHECK has been received from the following sources: Medical Research Council [MR/V034405/1]; UCL/Wellcome [ISSF3/H17RCO/C3]; Rosetrees [M952]; Economic and Social Research Council [ES/V009931/1]; as well as seed funding from National Institute for Health Research Maudsley Biomedical Research Centre, King’s College London, National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King’s College London. This research was supported by the National Institute for Health Research ARC North Thames. The authors wish to acknowledge the National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) National NHS and Social Care Workforce Group, with the following ARCs: East Midlands, East of England, South West Peninsula, South London, West, North West Coast, Yorkshire and Humber, and North East and North Cumbria. They enabled the set-up of the national network of participating hospital sites and aided the research team to recruit effectively during the COVID-19 pandemic. The NHS CHECK consortium includes the following site leads: Sean Cross, Amy Dewar, Chris Dickens, Frances Farnworth, Adam Gordon, Charles Goss, Jessica Harvey, Nusrat Husain, Peter Jones, Damien Longson, Richard Morriss, Jesus Perez, Mark Pietroni, Ian Smith, Tayyeb Tahir, Peter Trigwell, Jeremy Turner, Julian Walker, Scott Weich, and Ashley Wilkie. The NHS CHECK consortium includes the following co-investigators and collaborators: Peter Aitken, Anthony David, Sarah Dorrington, Rosie Duncan, Cerisse Gunasinghe, Stephani Hatch, Daniel Leightley, Isabel McMullen, Martin Parsons, Paul Moran, Catherine Polling, Alexandra Pollitt, Danai Serfioti, Chloe Simela, and Charlotte Wilson Jones.
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023/3/8
Y1 - 2023/3/8
N2 - Background: Potentially morally injurious events (PMIEs) can negatively impact mental health. The COVID-19 pandemic may have placed healthcare staff at risk of moral injury. Aim: To examine the impact of PMIE on healthcare staff wellbeing. Methods: Twelve thousand nine hundred and sixty-five healthcare staff (clinical and non-clinical) were recruited from 18 NHS-England trusts into a survey of PMIE exposure and wellbeing. Results: PMIEs were significantly associated with adverse mental health symptoms across healthcare staff. Specific work factors were significantly associated with experiences of moral injury, including being redeployed, lack of PPE, and having a colleague die of COVID-19. Nurses who reported symptoms of mental disorders were more likely to report all forms of PMIEs than those without symptoms (AOR 2.7; 95% CI 2.2, 3.3). Doctors who reported symptoms were only more likely to report betrayal events, such as breach of trust by colleagues (AOR 2.7, 95% CI 1.5, 4.9). Conclusion: A considerable proportion of NHS healthcare staff in both clinical and non-clinical roles report exposure to PMIEs during the COVID-19 pandemic. Prospective research is needed to identify the direction of causation between moral injury and mental disorder as well as continuing to monitor the longer term outcomes of exposure to PMIEs.
AB - Background: Potentially morally injurious events (PMIEs) can negatively impact mental health. The COVID-19 pandemic may have placed healthcare staff at risk of moral injury. Aim: To examine the impact of PMIE on healthcare staff wellbeing. Methods: Twelve thousand nine hundred and sixty-five healthcare staff (clinical and non-clinical) were recruited from 18 NHS-England trusts into a survey of PMIE exposure and wellbeing. Results: PMIEs were significantly associated with adverse mental health symptoms across healthcare staff. Specific work factors were significantly associated with experiences of moral injury, including being redeployed, lack of PPE, and having a colleague die of COVID-19. Nurses who reported symptoms of mental disorders were more likely to report all forms of PMIEs than those without symptoms (AOR 2.7; 95% CI 2.2, 3.3). Doctors who reported symptoms were only more likely to report betrayal events, such as breach of trust by colleagues (AOR 2.7, 95% CI 1.5, 4.9). Conclusion: A considerable proportion of NHS healthcare staff in both clinical and non-clinical roles report exposure to PMIEs during the COVID-19 pandemic. Prospective research is needed to identify the direction of causation between moral injury and mental disorder as well as continuing to monitor the longer term outcomes of exposure to PMIEs.
UR - http://www.scopus.com/inward/record.url?scp=85150508095&partnerID=8YFLogxK
U2 - 10.1080/09638237.2023.2182414
DO - 10.1080/09638237.2023.2182414
M3 - Article
SN - 0963-8237
VL - 32
SP - 890
EP - 898
JO - Journal of Mental Health
JF - Journal of Mental Health
IS - 5
ER -
