Betrayal-Based Moral Injury and Mental Health Problems Among Healthcare and Hospital Workers Serving COVID-19 Patients.
Betrayal-Based Moral Injury and Mental Health Problems Among Healthcare and Hospital Workers Serving COVID-19 Patients.
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为 COVID-19 患者提供服务的医疗保健和医院工作人员中基于背叛的道德伤害和心理健康问题。
DOI：
10.1080/15299732.2023.2289195
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Veenema,TenerG
中科院分区：
文献类型：
--
作者：
Park,Soim;Thrul,Johannes;Cooney,ErinE;Atkins,Kaitlyn;Kalb,LutherG;Closser,Svea;McDonald,KathrynM;Schneider-Firestone,Sarah;Surkan,PamelaJ;Rushton,CyndaH;Langhinrichsen-Rohling,Jennifer;Veenema,TenerG
在COVID-19大流行期间，可能导致医疗保健和医院工作人员（HHW）心理健康下降的一个因素是感觉被机构领导人，同事和/或其他人的流行病相关反应和行为背叛。我们调查了HHWs基于背叛的道德伤害是否与COVID-19相关的更大的精神痛苦和创伤后应激障碍（PTSD）症状有关。我们还研究了这些协会之间的临床和非临床工作人员的变化。于2020年7月至2021年1月，我们从美国一个大型城市医疗系统中为COVID-19患者提供服务的1，066名医护人员收集了横断面在线调查数据。我们在三个群体中测量了基于背叛的道德伤害：机构领导人，同事/同事和医疗保健以外的人。采用多因素Logistic回归分析，探讨背叛性精神伤害是否与精神痛苦和PTSD症状相关。大约三分之一的卫生保健工作者报告说，他们感到被机构领导人和/或医疗保健以外的人背叛。临床工作人员比非临床工作人员更容易报告背叛的感觉。在所有受访者中，49.5%的人报告精神困扰，38.2%的人报告PTSD症状。有任何背叛的感觉会使精神痛苦和PTSD症状的几率分别增加2.9倍和3.3倍。临床和非临床工作人员之间的这些协会没有显着差异。随着卫生系统寻求加强对卫生保健工作者的支持，它们需要仔细审查可能导致工作人员感到背叛的体制结构、问责制、沟通和决策模式。与HHWs建立信任和修复破裂可以预防潜在的心理健康问题，增加保留，并减少倦怠，同时可能改善患者护理。
One factor potentially driving healthcare and hospital worker (HHW)’s declining mental health during the COVID-19 pandemic is feeling betrayed by institutional leaders, coworkers, and/or others’ pandemic-related responses and behaviors. We investigated whether HHWs’ betrayal-based moral injury was associated with greater mental distress and post-traumatic stress disorder (PTSD) symptoms related to COVID-19. We also examined if these associations varied between clinical and non-clinical staff. From July 2020 to January 2021, cross-sectional online survey data were collected from 1,066 HHWs serving COVID-19 patients in a large urban US healthcare system. We measured betrayal-based moral injury in three groups: institutional leaders, coworkers/colleagues, and people outside of healthcare. Multivariate logistic regression analyses were performed to investigate whether betrayal-based moral injury was associated with mental distress and PTSD symptoms. Approximately one-third of HHWs reported feeling betrayed by institutional leaders, and/or people outside healthcare. Clinical staff were more likely to report feelings of betrayal than non-clinical staff. For all respondents, 49.5% reported mental distress and 38.2% reported PTSD symptoms. Having any feelings of betrayal increased the odds of mental distress and PTSD symptoms by 2.9 and 3.3 times, respectively. These associations were not significantly different between clinical and non-clinical staff. As health systems seek to enhance support of HHWs, they need to carefully examine institutional structures, accountability, communication, and decision-making patterns that can result in staff feelings of betrayal. Building trust and repairing ruptures with HHWs could prevent potential mental health problems, increase retention, and reduce burnout, while likely improving patient care.
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影响因子：
7.6
作者：
Brewer, MB;Gardner, W
通讯作者：
Gardner, W
影响因子：
6.6
作者：
Loewe, Bernd;Wahl, Inka;Braehler, Elmar
通讯作者：
Braehler, Elmar
加拿大医疗系统中的患者不满和机构背叛：一项定性研究
影响因子：
3.3
作者：
Andreea Tamaian;Bridget Klest;C. Mutschler
通讯作者：
C. Mutschler
DOI：
10.1037/tra0000347
发表时间：
2018-05-01
影响因子：
6.3
作者：
Evans, Wyatt R.;Stanley, Melinda A.;Teng, Ellen J.
通讯作者：
Teng, Ellen J.
影响因子：
4.4
作者：
Zhizhong W;Koenig HG;Yan T;Jing W;Mu S;Hongyu L;Guangtian L
通讯作者：
Guangtian L