Guy Catherine, Kunonga Edward, Kennedy Angela, Patel Paras
Medical Directorate, West Park Hospital, Tees Esk and Wear Valleys NHS Trust, Darlington, UK
Public Health England, Newcastle, UK.
BMJ Lead. 2022 Sep;6(3):237-239. doi: 10.1136/leader-2021-000518. Epub 2022 Jan 12.
Essential workers have faced many difficult situations working during the pandemic. Staff may feel that they, or other people, have acted wrongly and be distressed by this. This represents moral injury, which has been linked with significant mental ill health.
This survey asked essential workers in County Durham and Darlington about their experiences during the first wave of the pandemic and anything they felt would help. Well-being and moral injury were rated using sliders.
There were 566 responses. A majority of respondents reported feeling troubled by other people's actions they felt were wrong (60% scored over 40, where 0 is 'not at all troubled' and 100 'very troubled', median score=52.5). Respondents were generally less troubled by their own actions (median score=3). Well-being and moral injury scores varied by employment sector (eg, National Health Service (NHS) staff were more troubled by the actions of others than non-NHS staff).Staff suggestions included regular supervisor check-ins, ensuring kindness from everyone, fair rules and enforcement and improving communication and processes. Respondents offered simple, practical actions that could be taken by leaders at team, organisation, societal and governmental levels to tackle moral injury and the underlying causes of moral injurious environments.
Using these findings to develop a strategy to address moral injury is important, not only for staff well-being, but staff retention and continued delivery of vital services in these challenging times. Working together, we can seek to reduce and mitigate 'moral injury' the same way we do for other physical workplace 'injuries'.
在疫情期间，一线工作者面临着诸多困难处境。员工可能会觉得自己或他人的行为不当，并因此感到苦恼。这就是道德伤害，它与严重的心理健康问题有关。
这项调查询问了达勒姆郡和达灵顿的一线工作者在疫情第一波期间的经历以及他们认为有帮助的任何事情。使用滑块对幸福感和道德伤害进行评分。
共收到566份回复。大多数受访者表示，他们对自己认为他人的错误行为感到困扰（60%的得分超过40分，0分为“完全不困扰”，100分为“非常困扰”，中位数得分=52.5）。受访者通常对自己的行为困扰较少（中位数得分=3）。幸福感和道德伤害得分因就业部门而异（例如，国民保健服务体系（NHS）的工作人员比非NHS工作人员更容易因他人的行为而困扰）。员工的建议包括主管定期检查、确保每个人都友善、公平的规则及执行，以及改善沟通和流程。受访者提出了一些简单、实际的行动，团队、组织、社会和政府层面的领导者可以采取这些行动来应对道德伤害以及造成道德伤害环境的潜在原因。
利用这些发现制定一项应对道德伤害的策略很重要，这不仅关乎员工的幸福感，还关乎员工留用以及在这些充满挑战的时期持续提供重要服务。我们可以共同努力，像应对其他工作场所的身体“伤害”一样，寻求减少和减轻“道德伤害”。
