Fantus Sophia, Cole Rebecca, Thomas Latisha, Usset Timothy J
School of Social Work, University of Texas at Arlington, Arlington, Texas, USA.
Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota, USA.
Stress Health. 2024 Dec;40(6):e3485. doi: 10.1002/smi.3485. Epub 2024 Sep 28.
Research has demonstrated that encounters of potentially moral injurious events (PMIEs) may result in longstanding psychological trauma that impact healthcare workers' mental health and well-being. In this paper, we explore strategies to alleviate PMIEs for medical social workers. In-depth semi-structured interviews (30-60 min) were conducted with medical social workers (n = 75) across the state of Texas. Supported by directed content analysis, textual data were coded and categorised to finalize emerging themes. Findings demonstrate that multilevel strategies ought to be implemented into daily healthcare practice. PMIEs that impact frontline healthcare delivery can be alleviated by having formal and informal support systems (e.g., mentorship, supervision, counselling) as well as honest and transparent interprofessional collaborative care to facilitate psychological team safety. PMIEs across the healthcare organisation, perhaps due to internal policies and practices, may be reduced by implementing educational initiatives and building ethical workplace cultures that serve to explicitly reduce stigma associated with mental health and enhance worker well-being. PMIEs that derive from macro-level social policies (e.g., insurance, health disparities) may be alleviated by instituting patient advocacy initiatives and dismantling systems of oppression to lessen psychological stress and trauma. Hospital leadership ought to understand how the United States healthcare industry triggers PMIEs across the healthcare workforce. Multi-tiered practices and policies that addresses frontline delivery care, leadership and administrative responsibilities, and the healthcare industry can enhance psychologically safe workplaces and elicit macro-level institutional reform in how health systems function. These findings have important implications for healthcare policy makers, practitioners, educators, and researchers to inform future research and practice development.
研究表明，遭遇潜在的道德伤害事件（PMIEs）可能会导致长期的心理创伤，影响医护人员的心理健康和幸福感。在本文中，我们探讨了减轻医疗社会工作者PMIEs的策略。我们对德克萨斯州的医疗社会工作者（n = 75）进行了深入的半结构化访谈（30 - 60分钟）。在定向内容分析的支持下，对文本数据进行编码和分类，以确定新出现的主题。研究结果表明，应将多层次策略应用于日常医疗实践中。通过建立正式和非正式的支持系统（如指导、监督、咨询）以及诚实和透明的跨专业协作护理，以促进心理团队安全，可以减轻影响一线医疗服务的PMIEs。通过实施教育举措和建立道德的工作场所文化，明确减少与心理健康相关的耻辱感并提高员工幸福感，可能会减少整个医疗组织中因内部政策和实践导致的PMIEs。通过开展患者倡导举措和消除压迫制度，以减轻心理压力和创伤，可以缓解源自宏观层面社会政策（如保险、健康差距）的PMIEs。医院领导应该了解美国医疗行业是如何在整个医护人员队伍中引发PMIEs的。解决一线医疗服务、领导和行政职责以及医疗行业问题的多层次实践和政策，可以增强心理安全的工作场所，并引发卫生系统运作方式的宏观层面制度改革。这些发现对医疗政策制定者、从业者、教育工作者和研究人员具有重要意义，可为未来的研究和实践发展提供参考。
