Morally injurious events and post-traumatic embitterment disorder in UK health and social care professionals during COVID-19: a cross-sectional web survey

Objective: To estimate the prevalence and predictors of morally injurious events (MIEs) and post-traumatic embitterment disorder (PTED) in UK health and social care professionals during the COVID-19 pandemic.

Design: Cross-sectional study.

Setting: September-October 2020 in the UK. Online survey hosted on Qualtrics, and recruited through Prolific.

Participants: 400 health and social care workers, aged 18 or above and living and working in the UK during the pandemic.

Main outcome measures: MIEs 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, self-esteem, resilient coping style, consideration of future consequences and personal belief in a just world.

Results: 19% of participants displayed clinical levels of PTED, and 73% experienced at least one COVID-related MIE. Exposure to occupational stressors increased the risk of experiencing PTED and MIEs, whereas personal belief in a procedurally just world, which is the belief that they experienced fair processes, was a protective mechanism.

Conclusions: MIEs and PTED are being experienced by UK health and social care professionals, particularly in those exposed to work-related stressors.