ABSTRACT

Background

The COVID-19 pandemic can affect the mental health of health and social care workers (HSCWs) who are frontline workers in this crisis. The pandemic poses unique challenges to HSCWs as they face morally daunting decisions while working with limited knowledge and resources. This study examined the relationships between exposure to potentially morally injurious events (PMIEs) and depression and anxiety among HSCWs.

Method

A sample of 243 Israeli HSCWs completed validated self-report questionnaires that include measures of depression, anxiety, exposure to PMIEs, perceived stress, and moral injury symptoms.

Results

About one-third (33.6%) of the sample met the criteria for major depressive disorder, 21.5% met the criteria for generalized anxiety disorder, and 19.1% reported comorbidity of depression and anxiety. Beyond demographic, COVID-19, and work-related characteristics, PMIEs contributed to depression and anxiety among HSCWs. The integrative model indicated the mediating role of perceived stress and moral injury symptoms in the associations of PMIEs with depression and anxiety.

Conclusions

The study’s findings highlight HSCWs’ mental burden during the COVID-19 pandemic and the important contribution of exposure to PMIEs to this burden. Clinicians treating HSCWs coping with depression and anxiety following the COVID-19 should also attend to moral injury symptoms.

中文翻译：

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受伤的帮手：在 COVID-19 大流行期间，道德伤害导致以色列卫生和社会护理工作者的抑郁和焦虑

摘要

背景

COVID-19 大流行会影响在这场危机中担任一线工作人员的卫生和社会护理工作者 (HSCW) 的心理健康。大流行给 HSCW 带来了独特的挑战，因为他们在知识和资源有限的情况下面临道德上令人生畏的决定。本研究检查了 HSCW 暴露于潜在道德伤害事件 (PMIE) 与抑郁和焦虑之间的关系。

方法

243 名以色列 HSCW 的样本完成了经过验证的自我报告问卷，其中包括抑郁、焦虑、PMIE 暴露、感知压力和道德伤害症状的测量。

结果

约三分之一（33.6%）的样本符合重度抑郁症标准，21.5%符合广泛性焦虑症标准，19.1%报告抑郁和焦虑共病。除了人口统计学、COVID-19 和与工作相关的特征外，PMIE 还导致 HSCW 的抑郁和焦虑。综合模型表明感知压力和道德损伤症状在 PMIE 与抑郁和焦虑的关联中的中介作用。

结论

该研究的结果突出了 HSCW 在 COVID-19 大流行期间的精神负担以及接触 PMIE 对这种负担的重要贡献。在 COVID-19 之后治疗患有抑郁症和焦虑症的 HSCW 的临床医生也应注意道德伤害症状。