University College London.
Division of Psychiatry, University College London.
Psychol Trauma. 2024 Oct;16(7):1189-1197. doi: 10.1037/tra0001519. Epub 2023 Jun 22.
Health and social care workers (HSCWs) have been shown to be at risk of exposure to potentially morally injurious events (PMIEs) and mental health problems during the COVID-19 pandemic. This study aimed to examine associations between exposure to PMIEs and meeting threshold criteria for probable posttraumatic stress disorder (PTSD) and probable complex PTSD (CPTSD) in U.K. HSCWs immediately after the peak of the first COVID-19 wave.
Frontline HSCWs from across the United Kingdom working in diverse roles in hospitals, nursing or care homes, and other community settings were recruited to the Frontline-COVID study via social media. Participants ( = 1,056) completed a cross-sectional online survey (May 27, 2020-July 23, 2020) which assessed exposure to PMIEs (nine-item Moral Injury Events Scale), and meeting symptom thresholds for probable PTSD and probable CPTSD (International Trauma Questionnaire).
PMIEs related to witnessing others' wrongful actions and betrayal events were more commonly endorsed than perceived self-transgressions. The rate of probable International Classification of Diseases, 11th Revision (ICD-11) PTSD was 8.3%, and of probable ICD-11 CPTSD was 14.2%. Betrayal-related PMIEs were a significant predictor of probable PTSD or probable CPTSD, together with having been redeployed during the pandemic. The only variable that differentially predicted probable CPTSD as compared with probable PTSD was not having had reliable access to personal protective equipment; none of the PMIE types were differential predictors for screening positive for probable PTSD versus probable CPTSD.
Exposure to PIMEs could be important for PTSD and CPTSD development. Interventions for moral injury in HSCWs should be investigated. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
在 COVID-19 大流行期间，卫生和社会保健工作者（HSCWs）已经暴露于潜在的道德伤害事件（PMIEs）和心理健康问题的风险之中。本研究旨在调查在 COVID-19 第一波高峰后，英国 HSCWs 接触 PMIEs 与符合创伤后应激障碍（PTSD）和复杂创伤后应激障碍（CPTSD）的可能诊断标准之间的关联。
通过社交媒体招募了来自英国各地的从事医院、护理或疗养院以及其他社区环境中的各种角色的一线 HSCWs 参加 Frontline-COVID 研究。参与者（n=1056）完成了一项横断面在线调查（2020 年 5 月 27 日至 7 月 23 日），该调查评估了 PMIEs（九项道德伤害事件量表）的暴露情况，以及符合 PTSD 和 CPTSD 的可能症状阈值（国际创伤问卷）。
与目睹他人的不当行为和背叛事件相关的 PMIEs 比感知到的自我越轨行为更常见。可能的国际疾病分类第 11 版（ICD-11）创伤后应激障碍的发生率为 8.3%，可能的 ICD-11 复杂创伤后应激障碍的发生率为 14.2%。背叛相关的 PMIEs 是 PTSD 或 CPTSD 的重要预测因素，与大流行期间的重新部署有关。唯一能够预测 CPTSD 而不是 PTSD 的变量是无法可靠获得个人防护设备；没有任何 PMIE 类型是 PTSD 与 CPTSD 筛查阳性的差异预测因素。
接触 PMIEs 可能对 PTSD 和 CPTSD 的发展很重要。应研究对 HSCWs 的道德伤害干预措施。
