A Duke University study shows that, amid COVID-19, US healthcare workers (HCWs) had similar rates of potential moral injury (PMI)—a type of trauma-induced wound to the psyche—as military combat veterans.The study, published yesterday in the Journal of General Internal Medicine, surveyed 2,099 HCWs in 2020 and 2021 and 618 military veterans deployed to a combat zone after the Sep 11, 2001, US terrorist attacks about PMIs they may have experienced.PMI is a distressing reaction to exposure to traumatic events that may have psychological, behavioral, social, and spiritual effects.Depression, lower quality of lifeOf the 618 veterans, 46.1% reported experiencing PMI induced by others' immoral actions, compared with 50.7% of HCWs, while 24.1% and 18.2%, respectively, reported being disturbed by violations of their own moral code.Combat veterans who reported PMIs induced by others had higher rates of depression; average Beck Depression Inventory-2 score among veterans reporting other-induced PMI was 22.34, versus 13.61 among those not reporting this type of PMI.
They also had lower quality of life (average Short Form Survey score, 46.70 vs 59.98, respectively).Likewise, compared with veterans who did not report self-induced PMI, those who did had significantly greater levels of depression (average Beck score, 24.55 vs 15.44) and lower quality of life (average Short Forum score, 45.71 vs 55.73).Other-induced PMI among HCWs was significantly tied to younger age and COVID-19 exposure, while self-induced PMI was linked with younger age, non-White race, working in a high-risk setting, and COVID-19 exposure.
Compared with HCWs who didn't report other-induced PMI, those who did had greater levels of depression on the Beck Inventory