ArticleJournal of psychiatric research2022
Associations between psychosocial stressors at work and moral injury in frontline healthcare workers and leaders facing the COVID-19 pandemic in Quebec, Canada: A cross-sectional study.
Article in Journal of psychiatric research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Severity and associated factors of moral injury in healthcare workers during the coronavirus pandemic: a comprehensive meta-analysis.Archives of public health = Archives belges de sante publique · 2025Pooled it
- Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- Pooled it
- Moral Injury as a Wound of Meaning and Conscience: An Introductory Synthesis of Conceptual Foundations, Spiritual Dimensions, and Clinical Implications.Journal of religion and health · 2026Article
- Psychosocial Impact of COVID-19 on Intensive Care Unit Personnel: A Repeated Cross-Sectional Survey Assessment Before, During, and After the First Peak.Healthcare (Basel, Switzerland) · 2026Article
- Moral injury in healthcare workers: causes & interventions.British medical bulletin · 2026Review
- Drivers to Stay or to Leave: Perceptions of the Nursing Work Environment Across Diverse Healthcare Sectors.Journal of nursing management · 2026Article
- Post-pandemic mental health: Understanding the global psychological burden and charting future research priorities.World journal of psychiatry · 2025Review
- Impact of the COVID-19 pandemic on the Canadian healthcare workforce: a rapid evidence synthesis of key considerations, lessons learned, and promising practices to address the healthcare workforce crisis.Health research policy and systems · 2025Article
- Canadian Nurses' Psychological Health Assessment and Its Determinants During the Uncertain Context of the Early COVID-19 Pandemic: A Cross-Sectional Study.Policy, politics & nursing practice · 2025Article
- Moral Injury Among Medical Personnel and First Responders Across Different Healthcare and Emergency Response Settings: A Narrative Review.International journal of environmental research and public health · 2025Review
- Identifying risk factors for burnout-driven turnover in Canadian healthcare workers during the Covid-19 pandemic.BMC health services research · 2025Article
- Vulnerability: An Interpretive Descriptive Study of Personal Support Workers' Experiences of Working During the COVID-19 Pandemic in Ontario, Canada.Healthcare (Basel, Switzerland) · 2024Article
- Moral distress, coping mechanisms, and turnover intent among healthcare providers in British Columbia: a race and gender-based analysis.BMC health services research · 2024Observational
- Mechanisms Explaining the Longitudinal Effect of Psychosocial Safety Climate on Work Engagement and Emotional Exhaustion among Education and Healthcare Professionals during the COVID-19 Pandemic.International journal of environmental research and public health · 2024Article
- Implementation of the Dementia Isolation Toolkit in long-term care improves awareness but does not reduce moral distress amongst healthcare providers.BMC health services research · 2024Article
- Psychosocial Risks among Quebec Healthcare Workers during the COVID-19 Pandemic: A Social Media Analysis.International journal of environmental research and public health · 2023Article
- When healers get wounded! Moral injury in healthcare providers during the COVID-19 pandemic in Pakistan.Frontiers in psychiatry · 2023Article
- Exploring the lived experiences of participants and facilitators of an online mindfulness program during COVID-19: a phenomenological study.Frontiers in public health · 2023Article
- 'Against everything that got you into the job': experiences of potentially morally injurious events among Canadian public safety personnel.European journal of psychotraumatology · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Healthcare workers (HCWs) on the frontline of the COVID-19 pandemic exhibit a high prevalence of depression and psychological distress. Moral injury (MI) can lead to such mental health problems. MI occurs when perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. Since the start of the pandemic, psychosocial stressors at work (PSWs) might have been exacerbated, which might in turn have led to an increased risk of MI in HCWs. However, research into the associations between PSWs and MI is lacking. Considering these stressors are frequent and most of them are modifiable occupational risk factors, they may constitute promising prevention targets. This study aims to evaluate the associations between a set of PSWs and MI in HCWs during the third wave of the COVID-19 pandemic in Quebec, Canada. Furthermore, our study aims to explore potential differences between urban and non-urban regions. The sample of this study consisted of 572 HCWs and leaders from the Quebec province. Prevalence ratios (PR) of MI and their 95% confidence intervals (CI) were modelled using robust Poisson regressions. Several covariates were considered, including age, sex, gender, socio-economic indicators, and lifestyle factors. Results indicated HCWs exposed to PSWs were 2.22-5.58 times more likely to experience MI. Low ethical culture had the strongest association (PR: 5.58, 95% CI: 1.34-23.27), followed by low reward (PR: 4.43, 95% CI: 2.14-9.16) and high emotional demands (PR: 4.32, 95% CI: 1.89-9.88). Identifying predictors of MI could contribute to the reduction of mental health problems and the implementation of targeted interventions in urban and non-urban areas.
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