Neil Greenberg and colleagues set out measures that healthcare managers need to put in place to protect the mental health of healthcare staff having to make morally challenging decisions The covid-19 pandemic is likely to put healthcare professionals across the world in an unprecedented situation, having to make impossible decisions and work under extreme pressures. These decisions may include how to allocate scant resources to equally needy patients, how to balance their own physical and mental healthcare needs with those of patients, how to align their desire and duty to patients with those to family and friends, and how to provide care for all severely unwell patients with constrained or inadequate resources. This may cause some to experience moral injury or mental health problems. Moral injury, a term that originated in the military, can be defined as the psychological distress that results from actions, or the lack of them, which violate someone’s moral or ethical code.1 Unlike formal mental health conditions such as depression or post-traumatic stress disorder, moral injury is not a mental illness. But those who develop moral injuries are likely to experience negative thoughts about themselves or others (for example, “I am a terrible person” or “My bosses don’t care about people’s lives”) as well as intense feelings of shame, guilt, or disgust. These symptoms can contribute to the development of mental health difficulties, including depression, post-traumatic stress disorder, and even suicidal ideation.2 Equally, some people who have to contend with significant challenges, moral or traumatic, experience a degree of post-traumatic growth,3 a term used to describe a bolstering of psychological resilience, esteem, outlook, and values after exposure to highly challenging situations. Whether someone develops a psychological injury or experiences psychological growth is likely to be influenced by the way that they are supported …

中文翻译：

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处理医护人员在covid-19大流行期间面临的心理健康挑战。

尼尔·格林伯格（Neil Greenberg）及其同事提出了一些措施，医护人员需要采取这些措施来保护医护人员的精神健康，从而不得不做出道德上具有挑战性的决定。covid-19大流行很可能使世界各地的医护专业人员处于前所未有的境地，做出不可能的决定，并在极端压力下工作。这些决定可能包括如何为同样有需要的患者分配很少的资源，如何平衡他们自己的身体和精神保健需求以及患者的需求，如何使他们对患者的渴望和责任与对家人和朋友的需求相一致，以及如何提供护理适用于所有资源有限或不足的严重不适的患者。这可能会导致某些人遭受精神伤害或心理健康问题。道德伤害，起源于军事，可以将其定义为因采取某种行动或缺乏某种行动而造成的心理困扰，这些行为违反了某人的道德或道德规范。1与诸如抑郁症或创伤后应激障碍等正式的心理健康状况不同，精神伤害不是精神疾病。但是那些遭受道德伤害的人很可能会对自己或他人产生消极的想法（例如，“我是一个可怕的人”或“我的老板不在乎人们的生活”）以及强烈的羞耻感，内感，或厌恶。这些症状可导致精神健康困难的发展，包括抑郁症，创伤后应激障碍甚至自杀意念。2同样，一些必须面对重大挑战（道德或创伤）的人会经历一定程度的创伤后成长，3这个术语用来描述在面临高度挑战的情况后增强心理适应力，自尊心，外表和价值观的能力。某人遭受心理伤害或经历心理成长可能会受到他们支持方式的影响……