Long-term impact of COVID-19 pandemic: Moral tensions, distress, and injuries of healthcare workers

PLoS One. 2024 Sep 27;19(9):e0298615. doi: 10.1371/journal.pone.0298615. eCollection 2024.

Abstract

Given the longevity of the COVID-19 pandemic, it is important to address the perceptions and experiences associated with the progression of the pandemic. This narrative can inform future strategies aimed at mitigating moral distress, injury, and chronic stress that restores resilience and well-being of HCWs. In this context, a longitudinal survey design was undertaken to explore how health care workers are experiencing the COVID-19 pandemic over time. A qualitative design was employed to analyze the open ended survey responses using a thematic analysis approach. All physicians and staff at an academic health science centre in Toronto, Ontario, Canada were invited to participate in the survey. The majority of survey respondents were nurses and physicians, followed by researchers/scientists, administrative assistants, laboratory technicians, managers, social workers, occupational therapists, administrators, clerks and medical imaging technologists. The inductive analysis revealed three themes that contributed to moral tensions and injury: 1) experiencing stress and distress with staffing shortages, increased patient care needs, and visitor restrictions; 2) feeling devalued and invisible due to lack of support and inequities; and 3) polarizing anti- and pro-public health measures and incivility. Study findings highlight the spectrum, magnitude, and severity of the emotional, psychological, and physical stress leading to moral injury experienced by the healthcare workforce. Our findings also point to continued, renewed, and new efforts in enhancing both individual and collective moral resilience to mitigate current and prevent future moral tensions and injury.

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Female
  • Health Personnel* / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Morals*
  • Ontario / epidemiology
  • Pandemics*
  • Psychological Distress
  • SARS-CoV-2
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires

Grants and funding

This work was supported by Canadian Institutes of Health Research (CIHR) Grant #440249 (2019 Novel Coronavirus (COVID-19) Rapid Research Funding(FRN OV7-170642)). The CIHR funding information can be reached at this URL: https://urldefense.com/v3/__https://cihr-irsc.gc.ca/e/37788.html__;!!G4DFHqrI2g!RPiP_kcporIsYLUrUzaOJfjneKKsZGG-PXvCeDlXEXM-JJC7u7hPDgP2OY_syc26ofduG7QMzt5SUhyHeooD$. The grant was applied for by RM as Nominated Principal Investigator with LJ serving as a Co-Applicant, and CIHR had no involvement in study design, data collection and analysis, decision to publish and preparation of the manuscript.