Evidence map›Paper›PMID 35264983›Full record

ReviewFrontiers in psychiatry2021

Healthcare Workers and COVID-19-Related Moral Injury: An Interpersonally-Focused Approach Informed by PTSD.

Andrea M D'Alessandro, Kimberly Ritchie, Randi E McCabe, Ruth A Lanius, Alexandra Heber, Patrick Smith, Ann Malain, Hugo Schielke, Charlene O'Connor, Fardous Hosseiny and 2 more

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

Review in Frontiers in psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
6.7field-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, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Professional Pride During COVID-19 in a Cohort of Healthcare Workers.International journal of environmental research and public health · 2026
    Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
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

12 authors at 6 institutions in 1 country.

Andrea M D'AlessandroNeuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.
Kimberly RitchieDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.
Randi E McCabeDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.
Ruth A LaniusDepartment of Psychiatry, University of Western, London, ON, Canada.
Alexandra HeberVeterans Affairs Canada, Ottawa, ON, Canada.
Patrick SmithCentre of Excellence on Post-Traumatic Stress Disorder, Ottawa, ON, Canada.
Ann MalainHomewood Health Centre, Guelph, ON, Canada.
Hugo SchielkeHomewood Health Centre, Guelph, ON, Canada.
Charlene O'ConnorHomewood Health Centre, Guelph, ON, Canada.
Fardous HosseinyCentre of Excellence on Post-Traumatic Stress Disorder, Ottawa, ON, Canada.
Sara RodriguesCentre of Excellence on Post-Traumatic Stress Disorder, Ottawa, ON, Canada.
Margaret C McKinnonDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.
Homewood Research Institute · CAMcMaster University · CAUniversity of Ottawa · CARoyal Ottawa Mental Health Centre · CASt. Joseph’s Healthcare Hamilton · CAVeterans Affairs Canada · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The COVID-19 pandemic has resulted in a still-unfolding series of novel, potentially traumatic moral and ethical challenges that place many healthcare workers at risk of developing moral injury. Moral injury is a type of psychological response that may arise when one transgresses or witnesses another transgress deeply held moral values, or when one feels that an individual or institution that has a duty to provide care has failed to do so. Despite knowledge of this widespread exposure, to date, empirical data are scarce as to how to prevent and, where necessary, treat COVID-19-related moral injury in healthcare workers. Given the relation between moral injury and post-traumatic stress disorder (PTSD), we point here to social and interpersonal factors as critical moderators of PTSD symptomology and consider how this knowledge may translate to interventions for COVID-19-related moral injury. Specifically, we first review alterations in social cognitive functioning observed among individuals with PTSD that may give rise to interpersonal difficulties. Drawing on Nietlisbach and Maercker's 2009 work on interpersonal factors relevant to survivors of trauma with PTSD, we then review the role of perceived social support, social acknowledgment and social exclusion in relation to potential areas of targeted intervention for COVID-19-related moral injury in healthcare workers. Finally, building on existing literature (e.g., Phoenix Australia-Centre for Posttraumatic Mental Health and the Canadian Centre of Excellence-PTSD, 2020) we conclude with individual and organizational considerations to bolster against the development of moral injury in healthcare workers during the pandemic.

Indexed as

COVID-19healthcare workersinterpersonal factorsmoral injurypost-traumatic stress disordersocial cognition

Identifiers

PMID35264983
PMCPMC8900218
OpenAlexW4212860885

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.