Whitehead, Phyllis B.Haisch, Carl E.Hankey, Maria S.Mutcheson, BrockDeWitt, Sarah A.Stewart, Christi A.Stewart, Jonathan D.Bath, Jennifer L.Boone, Sherry M.Jileaeva, IlonaFaulks, Emily R.Musick, David W.2023-10-092023-10-092023-10-09http://hdl.handle.net/10919/116433Background: COVID-19 increased moral distress (MD) and moral injury (MI) among healthcare professionals (HCPs). MD and MI were studied among inpatient and outpatient HCPs during March 2022. Objectives: We sought to examine (1) the relationship between MD and MI; (2) the relationship between MD/MI and pandemic-related burnout and resilience; and (3) the degree to which HCPs experienced pandemic-related MD and MI based on their background. Methods: A survey was conducted to measure MD, MI, burnout, resilience, and intent to leave healthcare at 2 academic medical centers during a 4-week period. A convenience sample of 184 participants (physicians, nurses, residents, respiratory therapists, advanced practice providers) completed the survey. In this mixed-methods approach, researchers analyzed both quantitative and qualitative survey data and triangulated the findings. Results: There was a moderate association between MD and MI (r = .47, P < .001). Regression results indicated that burnout was significantly associated with both MD and MI (P = .02 and P < .001, respectively), while intent to leave was associated only with MD (P < .001). Qualitative results yielded 8 sources of MD and MI: workload, distrust, lack of teamwork/collaboration, loss of connection, lack of leadership, futile care, outside stressors, and vulnerability. Conclusions: While interrelated conceptually, MD and MI should be viewed as distinct constructs. HCPs were significantly impacted by the COVID-19 pandemic, with MD and MI being experienced by all HCP categories. Understanding the sources of MD and MI among HCPs could help to improve well-being and work satisfaction.Pages 1-18application/pdfenIn Copyright3202 Clinical sciences4206 Public health5203 Clinical and health psychologyArticle - Refereed2023-10-09https://doi.org/10.1177/009121742312056602023Musick, David [0000-0002-4590-5335]Whitehead, Phyllis [0000-0001-9530-1102]DeWitt, Sarah [0000-0002-9766-6196]Stewart, Jonathan [0009-0000-0095-3133]