Morally injurious events and posttraumatic embitterment disorder in U.K. health and social care professionals during COVID-19: A longitudinal web survey.

ABSTRACT

OBJECTIVE: To longitudinally estimate the prevalence and predictors of potentially morally injurious events (PMIEs) and posttraumatic embitterment disorder (PTED) and in U.K. health and social care workers (HSCWs) during the COVID-19 pandemic. Additionally, to investigate the mechanism by which PMIEs increase embitterment by lowering personal belief in procedural justice, that is, the belief that they experience fair processes. METHOD: An online longitudinal survey was hosted on Qualtrics between September-October 2020 and September-November 2021. Using Prolific, 400 HSCWs aged 18 or above and working in the United Kingdom during the pandemic were recruited. PMIEs were assessed using the Moral Injury Events Scale, and PTED was assessed using the PTED self-rating scale. Potential predictors were measured using surveys of exposure to occupational stressors, optimism, pessimism, self-esteem, resilient coping style, consideration of future consequences, and personal just world beliefs. RESULTS: Seventy-one percent of participants experienced at least one COVID-related PMIE and 20% displayed clinically relevant signs of PTED at Time 2 in 2021. Exposure to occupational stressors increased the risk of experiencing PMIEs and PTED, whereas personal belief in a procedurally just world protected against transgressions by others and betrayal PMIEs. Self-esteem was protective, and a resilient coping style was a risk for experiencing betrayal. PMIEs increased embitterment by lowering personal belief in procedural justice over a 12-month period. CONCLUSIONS: PMIEs and PTED are being experienced by U.K. HSCWs in 2020 and 2021, particularly in those exposed to work-related stressors. Exposure to PMIEs increases the risk of embitterment by lowering belief in procedural justice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).