Institute of Psychology, University of Innsbruck, Innrain, 52f, 6020 Innsbruck, Austria.
Department of Art and Design, University of the Arts Bremen, 28217 Bremen, Germany.
Int J Environ Res Public Health. 2022 Feb 1;19(3):1666. doi: 10.3390/ijerph19031666.
Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed = 149,394 studies from Web of Science and = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.
在大流行期间，医疗工作者（HCWs）面临的伦理困境突显了道德压力源和道德困境（MD）以及潜在的道德伤害事件（PMIEs）和道德伤害（MI）的核心地位。这些概念为理解医疗保健环境中的工作场所压力源提供了一种新方法，尤其是在 COVID-19 的艰难时期，但它们目前缺乏对原因和后果的明确识别。使用基于截至 2021 年 10 月发表的文章的 Web of Science Core Collection 和 PsycINFO 数据库，对 COVID-19 期间医疗保健工作者的道德压力源、道德困境、PMIEs 和 MI 进行了范围综述。研究是根据以下纳入标准选择的：（1）测量 HCWs 中的道德压力、MD、PMIEs 或 MI 之一；（2）使用定性或定量方法进行的原始研究；（3）可提供英文或德文同行评审的原始文章。最初的搜索显示，Web of Science 有 149394 项研究，EBSCOhost 有 34 项研究。综述共纳入 19 项研究。提出并讨论了 COVID-19 期间医疗保健环境中代表道德压力源和 PMIEs 以及 MD 和 MI 作为其潜在结果的条件。在 COVID-19 期间强调 HCWs 中的 MD 和 MI 引起了人们对概念化任何程度的道德压力源影响的必要性的关注。因此，需要开发一种共同的、基于理论的 MD 和 MI 模型。
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