A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during Covid-19

Bibliographic Data

ID23334756
AuthorsPriya-Lena Riedel (0000-0002-6729-6278, Institute of Psychology, University of Innsbruck, Innrain, 52f, 6020 Innsbruck, Austria), Alexander Kreh (0000-0002-4369-6330, Institute of Psychology, University of Innsbruck, Innrain, 52f, 6020 Innsbruck, Austria), Vanessa Kulcar (0000-0003-3057-573X, Institute of Psychology, University of Innsbruck, Innrain, 52f, 6020 Innsbruck, Austria), Angela Lieber (University of the Arts Bremen), Barbara Juen (0000-0001-6878-8824, Institute of Psychology, University of Innsbruck, Innrain, 52f, 6020 Innsbruck, Austria)
Year2022
Volume19
Issue3
Pages1666
Publication date2022-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMDPI AG (PUBLISHER • IT)
DOI10.3390/ijerph19031666
LanguageEN
Citations received54
References cited73

Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.

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