McMaster University, Hamilton, Ontario, Canada.
Homewood Research Institute, Guelph, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2023 Nov;43(10-11):460-471. doi: 10.24095/hpcdp.43.10/11.04.
Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic.
Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected.
One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small.
Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.
在 COVID-19 大流行期间，呼吸治疗师（RT）面临着道德困境，包括在资源有限的情况下工作，并为临终患者的家属提供视频通话。道德困境与一系列不良的心理和功能结果（例如抑郁、焦虑、创伤后应激障碍 [PTSD] 的症状和功能障碍）以及离职考虑有关。本研究的目的是了解 COVID-19 大流行期间加拿大 RT 离职考虑的道德困境及其相关心理和功能结果对其的影响。
加拿大 RT（N=213）于 2021 年 2 月至 6 月期间完成了在线调查。收集了基本的人口统计学信息（例如年龄、性别、性别）和道德困境、抑郁、焦虑、压力、创伤后应激障碍、分离、功能障碍、弹性和不良童年经历的心理测量学验证措施。
四分之一的 RT 报告考虑离开他们的岗位。考虑离职的 RT 报告的道德困境和不良心理及功能结果水平高于不考虑离职的 RT。超过一半（54.5%）考虑离职的人得分高于潜在 PTSD 诊断的截止值。以前考虑离职和过去离职都会显著增加目前考虑离职的可能性，以及与系统相关的道德困境和 PTSD 症状，但这些因素的贡献很小。
考虑离职的加拿大 RT 报告的困境和不良心理及功能结果水平较高，但这些个体因素似乎不太可能是 RT 离职考虑的主要因素，因为它们的影响较小。需要进一步研究以确定可能导致加拿大 RT 离职考虑的更广泛的组织因素。
