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European Journal of Psychotraumatology Volume 13, 2022 - Issue 2
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Basic Research Article

‘It hurts your heart’: frontline healthcare worker experiences of moral injury during the COVID-19 pandemic

‘Duele tu corazón’: experiencias de daño moral durante la pandemia de COVID-19 en trabajadores de la salud de primera línea

‘它伤了你的心’：在 COVID-19 疫情期间一线医护人员的道德伤害经历

Siobhan Hegartya Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-4804-8797View further author information
ORCID Icon,
Danielle Lambb Department of Applied Health Research, University College London, London, UKView further author information
,
Sharon A. M. Stevelinka Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
,
Rupa Bhundiaa Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
,
Rosalind Raineb Department of Applied Health Research, University College London, London, UKView further author information
,
Mary Jane Dohertyc South London and Maudsley NHS Foundation Trust, London, UKView further author information
,
Hannah R. Scotta Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
,
Anne Marie Raffertyd Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UKView further author information
,
Victoria Williamsona Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK;e Department of Experimental Psychology, University of Oxford, Oxford, UKView further author information
,
Sarah Dorringtona Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
,
Matthew Hotopfa Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK;c South London and Maudsley NHS Foundation Trust, London, UKView further author information
,
Reza Razavif King’s Wellcome Trust EPSRC Centre For Medical Engineering, London, UKView further author information
,
Neil Greenberga Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
&
Simon Wesselya Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKView further author information
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Article: 2128028 | Received 31 May 2022, Accepted 30 Aug 2022, Published online: 18 Oct 2022

Citations (32)

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Sara Ahmed Pihlgren, Lotta Johansson, Emily A. Holmes & Marie Kanstrup. (2024) Exploring healthcare workers’ experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis. European Journal of Psychotraumatology 15:1.
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Andrea M. D’Alessandro-Lowe, Herry Patel, Bethany Easterbrook, Kim Ritchie, Andrea Brown, Yuanxin Xue, Mauda Karram, Heather Millman, Emily Sullo, Mina Pichtikova, Andrew Nicholson, Alex Heber, Ann Malain, Charlene O’Connor, Hygge Schielke, Sarah Rodrigues, Fardous Hosseiny, Randi E. McCabe, Ruth A. Lanius & Margaret C. McKinnon. (2024) The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic. European Journal of Psychotraumatology 15:1.
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Bruno Messina Coimbra, Cecilia Zylberstajn, Mirjam van Zuiden, Chris Maria Hoeboer, Andrea Feijo Mello, Marcelo Feijo Mello & Miranda Olff. (2024) Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis. European Journal of Psychotraumatology 15:1.
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Sarah Rabin, Natalia Kika, Danielle Lamb, Dominic Murphy, Sharon AM Stevelink, Victoria Williamson, Simon Wessely & Neil Greenberg. (2023) Moral Injuries in Healthcare Workers: What Causes Them and What to Do About Them?. Journal of Healthcare Leadership 15, pages 153-160.
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Kirti Singhal & Surekha Chukkali. (2023) The role of guilt-shame proneness and locus of control in predicting moral injury among healthcare professionals. Cogent Psychology 10:1.
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Yossi Levi-Belz, Yoav Groweiss & Carmel Blank. (2023) Moral injury and its mental health consequences among protesters: findings from Israel’s civil protest against the government's judicial reform. European Journal of Psychotraumatology 14:2.
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Julian D. Ford & Soraya Seedat. (2023) On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021–2023. European Journal of Psychotraumatology 14:2.
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Edita Fino, Judith K. Daniels, Giulia Micheli, Domenica Gazineo, Lea Godino, Guglielmo Imbriaco, Marco Antognoli, Luisa Sist, Domenico Regano, Roberta Decaro, Monica Guberti & Michela Mazzetti. (2023) Moral injury in a global health emergency: a validation study of the Italian version of the Moral Injury Events Scale adjusted to the healthcare setting. European Journal of Psychotraumatology 14:2.
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Sara Rodrigues, Jean-Michel Mercier, Adelina McCall, Molly Nannarone & Fardous Hosseiny. (2023) ‘Against everything that got you into the job’: experiences of potentially morally injurious events among Canadian public safety personnel. European Journal of Psychotraumatology 14:2.
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F. Jackie June ter Heide & Miranda Olff. (2023) Widening the scope: defining and treating moral injury in diverse populations. European Journal of Psychotraumatology 14:2.
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Articles from other publishers (22)

Benjamin M. Campbell, Michael A. Knipp, Sinan S. Anwar & Rachel A. Hoopsick. (2023) Moral injury and substance use among United States healthcare workers. Stress and Health 40:3.
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JohnBosco Chika Chukwuorji, Michael Onwe Nwogiji, Chuka Mike Ifeagwazi, Okechukwu Hope Eke, Dumkelechuku Obed-Ohen, Oluchi Miracle Osondu, Dwi Kartika Rukmi, Crystal Njoku & Adaeze Chike-Okoli. (2024) How Moral Distress Contributes to Depression Varies by Gender in a Sample of Sub-Saharan African Nurses. Psychiatry International 5:2, pages 205-216.
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Theresa Burgess, Stuart Rennie & Keymanthri Moodley. (2024) Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19. Research Ethics.
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Chloe Kitto, Danielle Lamb & Jo Billings. (2023) Responding to the call of the NHS Nightingale, but at what cost? An auto-ethnography of a volunteer frontline mental health trainer’s experiences during the COVID-19 pandemic. Journal of Health Psychology 29:6, pages 534-551.
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Elanor Lucy Webb, Deborah J. Morris, Benedetta Lupattelli Gencarelli & Jemima Worsfold. (2024) The differential and accumulative impacts of self and other sources of moral injury on well-being in mental healthcare staff. International Journal of Workplace Health Management.
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Janet M. de Groot, Danielle S. Miller, Kelcie D. Willis, Tamara Green, Lynn Calman, Andrea Feldstain, Seema R. Rao, Ozan Bahcivan & Dwain C. Fehon. (2024) Trauma-informed palliative care for humanitarian crises. Journal of Psychosocial Oncology Research and Practice 6:2.
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Fiona McNicholas & Aoife Twohig. (2024) Trauma and warfare and clinicians’ role. Pediatric Research.
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Guy M. Weissinger, Deborah Swavely, Heidi Holtz, Katherine C. Brewer, Mary Alderfer, Lisa Lynn, Angela Yoder, Thomas Adil, Tom Wasser, Danielle Cifra & Cynda Rushton. (2024) Critical Care Nurses’ Moral Resilience, Moral Injury, Institutional Betrayal, and Traumatic Stress After COVID-19. American Journal of Critical Care 33:2, pages 105-114.
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Chloe J Brennan, Carl Roberts & Jon C Cole. (2024) Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis. BMJ Open 14:2, pages e071776.
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Travis Fulton, Emma C. Lathan, Maya C. Karkare, Alfonsina Guelfo, Leyla Eghbalzad, Vishwadeep Ahluwalia, Timothy D. Ely, Jessica A. Turner, Matthew D. Turner, Joseph M. Currier, Yara Mekawi & Negar Fani. (2024) Civilian Moral Injury and Amygdala Functional Connectivity During Attention to Threat. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging 9:1, pages 112-120.
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Jina L. Sinskey, Joyce M. Chang, Amy C. Lu & May C. Pian-Smith. (2023) Patient Safety and Clinician Well-Being. Anesthesiology Clinics 41:4, pages 739-753.
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Hong Tao, Jason A. Nieuwsma, Keith G. Meador, Stephanie L. Harris & Patricia S. Robinson. (2023) Validation of the Moral Injury Outcome Scale in acute care nurses. Frontiers in Psychiatry 14.
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Madah Fatima, Nazish Imran, Irum Aamer, Somia Iqtadar & Bilquis Shabbir. (2023) When healers get wounded! Moral injury in healthcare providers during the COVID-19 pandemic in Pakistan. Frontiers in Psychiatry 14.
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Laura Woodward. 2023. Mental Wellbeing and Positive Psychology for Veterinary Professionals. Mental Wellbeing and Positive Psychology for Veterinary Professionals 75 188 .
Kevin D. Evans, Isaiah W. Bloom & Carolyn M. Sommerich. (2023) All the King’s Horses and All the King’s Men: Falling Into Moral Injury, During the COVID-19 Pandemic. Journal of Diagnostic Medical Sonography 39:5, pages 540-543.
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Xiaoxi Zhang, Helgi Johannsson, Joseph D. Tucker, Amardeep Riyat, Yuan-Li Tiffany Chiu, Neil Greenberg & Roger Sharpe. (2023) ‘Thrown in at the deep end’: a qualitative analysis into the transition from trainee to consultant during the COVID-19 pandemic and lessons for the future. BJA Open 7, pages 100217.
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Amos Simms, D Leightley & D Lamb. (2023) Caring for the carers: an evaluation of the recovery, readjustment and reintegration programme (R3P). BMJ Military Health, pages e002359.
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Evija Nagle, Sanita Šuriņa & Ingūna Griškēviča. (2023) Healthcare Workers’ Moral Distress during the COVID-19 Pandemic: A Scoping Review. Social Sciences 12:7, pages 371.
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Danielle Lamb, Sharon A M Stevelink, Hannah R Scott, Neil Greenberg & Simon Wessely. (2023) COVID-19 and the mental health of health-care workers. The Lancet Psychiatry 10:4, pages 245.
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Jo Billings. (2023) The effect of the COVID-19 pandemic on health-care workers. The Lancet Psychiatry 10:1, pages 3-5.
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Peter Schröder-Bäck. 2023. DenkWege - Ethik und Seelsorge in der Polizei. DenkWege - Ethik und Seelsorge in der Polizei 81 99 .
Keun-joo Christine PaeKeun-joo Christine Pae. 2023. A Transpacific Imagination of Theology, Ethics, and Spiritual Activism. A Transpacific Imagination of Theology, Ethics, and Spiritual Activism 87 128 .

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