Abstract
Introduction:In the context of the global pandemic of the SARS-CoV-2 coronavirus (COVID-19), healthcare providers (HCPs) have experienced difficult moral and ethical dilemmas. Research is highlighting the importance of moral injury (MI)–a trauma syndrome related to transgressing personal morals and values–in understanding the psychological harm and occupational impairment experienced by HCPs. To date, MI treatments have largely been developed for military personnel and veterans and rely on in-person one-on-one psychotherapy.Purpose:This project aims to explore the feasibility and acceptability of an evidence-informed online Acceptance and Commitment Therapy-based group therapy for MI in HCPs called “Accepting Moral Pain and Suffering for Healthcare Providers” (AMPS-HCP).Method:This feasibility and acceptability study included three separate phases with the first two phases focused on the development of the psychotherapeutic intervention and the third phase focused on the evaluation of the psychotherapeutic intervention. Eight participants (including registered nurses, practical nurses and respiratory therapists) completed seven 90-min sessions in an online group format. The focus of these sessions included ACT and MI psychoeducation and experientials. Qualitative semi-structured interview data was thematically analyzed while demographic and quantitative self-reported outcome data underwent descriptive analysis and non-parametric testing.Results:Results show that the intervention was highly feasible and acceptable to healthcare providers who worked on the frontline during COVID-19. Feasibility (referrals, eligibility, retention, participation engagement) was strong (8 out of 10 participants; 80% vs. desired >70% eligibility) and overall, 80% of participants completed 71% of the intervention. Data further supported the applicability and acceptability of the intervention. Preliminary data suggests that AMPS-HCP may supports HCPs to address MI.Discussion:This study is the first to report on the development and evaluation of an online MI group intervention for registered nurses, registered practical nurses, and respiratory therapists working during COVID-19. Results showed the use of both the online and group components of the intervention were acceptable and feasible during the third wave of COVID-19.
Highlights
In the context of the global pandemic of the SARS-CoV-2 coronavirus (COVID-19), healthcare providers (HCPs) have experienced difficult moral and ethical dilemmas
During the COVID-19 pandemic, HCPs across the globe have faced difficult moral and ethical decisions related to the enormous influx of patients with life-threatening conditions, resource limitations, system overload, policy changes, secondment, societal, and political stigma and denial, family needs, exposure to mass death and dying, as well as personal elevated exposure risk for COVID-19 [2, 3]
Emotional and psychological distress experienced by HCPs was not necessarily associated exclusively with SARS trauma; rather it was compounded with issues related to quarantine, fear of contagion, concern for family, job stress, interpersonal isolation, perceived stigma, and conscription of non-specialists into infectious disease work [13]
Summary
In the context of the global pandemic of the SARS-CoV-2 coronavirus (COVID-19), healthcare providers (HCPs) have experienced difficult moral and ethical dilemmas. HCPs have been stigmatized as vectors of contagion, resulting in their assault, abuse, and isolation during the COVID-19 pandemic [4, 5]. This situation has caused many HCPs to feel helplessness, shame, anger, and guilt as hundreds of patients every day succumb to the illness [6, 7]. Emotional and psychological distress experienced by HCPs was not necessarily associated exclusively with SARS trauma; rather it was compounded with issues related to quarantine, fear of contagion, concern for family, job stress, interpersonal isolation, perceived stigma, and conscription of non-specialists into infectious disease work [13]
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