Evidence map›Paper›PMID 34367526›Full record

ArticleEuropean journal of psychotraumatology

Moral injury and mental health outcomes among Israeli health and social care workers during the COVID-19 pandemic: a latent class analysis approach.

Gadi Zerach, Yossi Levi-Belz

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of psychotraumatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. The Association of Moral Injury and Healthcare Clinicians' Wellbeing: A Systematic Review.International journal of environmental research and public health · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Gadi ZerachDepartment of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel.ORCID https://orcid.org/0000-0002-5409-196X
Yossi Levi-BelzDepartment of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.ORCID https://orcid.org/0000-0002-8865-5639
Ariel University · ILRuppin Academic Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic poses unique challenges to health and social care workers (HSCWs) who face morally challenging and life-threatening decisions. Following exposure to events that transgress moral beliefs and expectations, HSCWs might experience psychological, social, and spiritual problems referred to as Moral Injury (MI).

objectiveThe objectives of this study were to examine patterns of exposure to potentially morally injurious events (PMIEs) among HSCWs and their associations with MI, mental health outcomes and psychological correlates.

methodA sample of 296 Israeli HSCWs volunteered to complete a cross-sectional electronic survey with validated self-report questionnaires in February and March 2021. Latent Class Analysis (LCA) was used to identify classes characterized by unique patterns of exposure to PMIEs. Socio-demographic, work and COVID-related variables were used to predict patterns of exposure to PMIEs, and differences in mental-health outcomes and psychological correlates between classes were assessed.

resultsThree subgroups were identified: 'high exposure' (19.5%), 'betrayal-only' (31.3%), and 'minimal exposure' (49.4%). Perceived stress increases the odds for inclusion in the 'high exposure' and 'betrayal-only' classes. Participants in both the High Exposure class and the betrayal-only classes reported higher levels of depressive, anxiety, posttraumatic and more moral injury symptoms as compared to the 'minimal exposure' class. Importantly, both 'high exposure' and 'betrayal-only' classes reported lower levels of self-compassion and higher levels of self-criticism, relative to those in the 'minimal exposure' class.

conclusionsThe study's findings offer an overview of the complex associations between patterns of exposure to PMIEs and associated predictors and outcomes. Clinicians treating HSCWs coping with COVID-19 related stress should be aware of the contribution of exposure to PMIEs to HSCWs' distress and to the unique constellation of high self-criticism and low self-compassion among HSCWs with exposure to PMIEs.

Indexed as

betrayalCOVID-19Daño moralhealthcare workersMoral injuryPTSDTEPTtrabajadores de saludtraición医护人员背叛道德伤害

Identifiers

PMID34367526
PMCPMC8312594
OpenAlexW3192390380

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.