Browsing by Author "Lorraine Smith-MacDonald"

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Open Access
Measuring moral distress and moral injury: A systematic review and content analysis of existing scales
(Elsevier BV, 2024-03) Stephanie A. Houle; Natalie Ein; Julia Gervasio; Rachel A. Plouffe; Brett T. Litz; R. Nicholas Carleton; Kevin T. Hansen; Jenny J.W. Liu; Andrea R. Ashbaugh; Walter Callaghan; Megan M. Thompson; Bethany Easterbrook; Lorraine Smith-MacDonald; Sara Rodrigues; Stéphanie A.H. Bélanger; Katherine Bright; Ruth A. Lanius; Clara Baker; William Younger; Suzette Bremault-Phillips; Fardous Hosseiny; J. Don Richardson; Anthony Nazarov
Background: Moral distress (MD) and moral injury (MI) are related constructs describing the negative conse- quences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. Method: We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific out- comes measured by each scale. Results: We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes.
Open Access
Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis
(MDPI AG, 2024-07-19) Chelsea Jones; Shaylee Spencer; Elly O’Greysik; Lorraine Smith-MacDonald; Katherine S. Bright; Amy J. Beck; R. Nicholas Carleton; Lisa Burback; Andrew Greenshaw; Yanbo Zhang; Phillip R. Sevigny; Jake Hayward; Bo Cao; Suzette Brémault-Phillips
Introduction: Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI. Methods: A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP. Discussion: Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP. Conclusion: By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities.