Department of Special Education, University of Haifa, Israel.
Department of Behavioral Sciences and Psychology, Ariel University, Israel.
Int J Soc Psychiatry. 2022 Aug;68(5):1026-1035. doi: 10.1177/00207640221099421. Epub 2022 May 30.
The COVID-19 pandemic can affect health and social care workers' (HSCWs') mental health in their role as frontline workers in this crisis. The pandemic poses unique challenges to HSCWs as they face morally daunting decisions while working with limited knowledge and resources. This study primary objective was to examine the moderating role of thwarted belongingness in the relationships between HSCWs' exposure to potentially morally injurious events (PMIEs) and moral injury symptoms, depression, and anxiety.
A sample of 296 Israeli HSCWs completed validated self-report questionnaires that include measures of depression, anxiety, PMIE exposure, moral injury symptoms, and a sense of thwarted belongingness.
About one-third (33.6%) of the sample met the criteria for major depression and 21.5% for generalized anxiety. Beyond demographic and work-related characteristics, PMIEs contributed to depression and anxiety levels. The indirect effect of PMIE exposure on anxiety/depression symptoms through MI symptoms was significant only at high levels of thwarted belongingness among HSCWs. Thus, greater PMIE exposure contributes to more MI symptoms, which, in turn, is linked to higher levels of anxiety/depression symptoms among HSCWs with high levels of thwarted belongingness.
Cross-sectional design, self-report questionnaires, sample limited to Israeli HSCWs.
The study's findings highlight the mental burden of HSCWs during the COVID-19 pandemic and the critical contribution of PMIE exposure and thwarted belongingness to this burden. Clinicians treating HSCWs coping with depression and anxiety following the COVID-19 should also attend to moral injury symptoms as well to the belongingness experience.
COVID-19 大流行可能会影响卫生保健工作者（HSCWs）作为这场危机中的一线工作者的心理健康。大流行给 HSCWs 带来了独特的挑战，因为他们在工作中面临着道德上令人畏惧的决策，同时只能利用有限的知识和资源。本研究的主要目的是考察受挫归属感在 HSCWs 接触潜在道德伤害事件（PMIEs）与道德伤害症状、抑郁和焦虑之间关系中的调节作用。
一个由 296 名以色列 HSCWs 组成的样本完成了经过验证的自我报告问卷，其中包括抑郁、焦虑、PMIE 暴露、道德伤害症状和受挫归属感的测量。
大约三分之一（33.6%）的样本符合重度抑郁症的标准，21.5%的样本符合广泛性焦虑症的标准。除了人口统计学和工作相关特征外，PMIEs 导致了抑郁和焦虑水平的升高。PMIE 暴露对焦虑/抑郁症状的间接影响仅在 HSCWs 受挫归属感高的情况下才具有统计学意义。因此，更多的 PMIE 暴露导致更多的 MI 症状，进而导致受挫归属感高的 HSCWs 出现更高水平的焦虑/抑郁症状。
横断面设计、自我报告问卷、仅限于以色列 HSCWs 的样本。
该研究结果突出了 COVID-19 大流行期间 HSCWs 的精神负担，以及 PMIE 暴露和受挫归属感对这一负担的重要贡献。治疗 COVID-19 后应对抑郁和焦虑的 HSCWs 的临床医生还应关注道德伤害症状以及归属感体验。
