Browsing by Author "Smith-MacDonald, Lorraine"

Now showing 1 - 4 of 4

Open Access
A Scoping Review of the Components of Moral Resilience: Its Role in Addressing Moral Injury or Moral Distress for High-Risk Occupation Workers
(Springer, 2023-12-14) Osifeso, Temitope; Crocker, Sierra J.; Lentz, Liana; Smith-MacDonald, Lorraine; Seliman, Merna; Limenih, Gojjam; MacPhee, Renée S.; Anderson, Gregory S.; Brémault-Phillips, Suzette; Malloy, David; Carleton, R. Nicholas
Purpose of Review: High-risk occupation workers (HROWs) are often exposed to potentially morally injurious events (PMIEs) which can contribute to moral distress (MD) or moral injury (MI). Moral resilience (MR) has been proposed as a protective or moderating factor to protect HROWs from harm caused by PMIE exposures. The current review was designed to: 1) update the definition of MR to a broader context of HROWs; 2) identify components of MR for HROWs; and 3) determine demographic variables that may impact MR development.
Open Access
Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers
(Frontiers Media, 2021-03-31) Lentz, Liana; Smith-MacDonald, Lorraine; Malloy, David; Carleton, R. Nicholas; Brémault-Phillips, Suzette
Background: Public Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.
Open Access
Meat in a Seat: A grounded theory study exploring moral injury in Canadian public safety communicators, firefighters, and paramedics
(Multidisciplinary Digital Publishing Institute, 2021-11-19) Smith-MacDonald, Lorraine; Lentz, Liana; Malloy, David; Brémault-Phillips, Suzette; Carleton, R. Nicholas
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.
Open Access
A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada
(Multidisciplinary Digital Publishing Institute, 2022-06-07) Lentz, Liana; Smith-MacDonald, Lorraine; Malloy, David, C.; Anderson, Gregory, S.; Beshai, Shadi; Ricciardelli, Rosemary; Bremault-Phillips, Suzette; Carleton, R. Nicholas
Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the available organizational mental health supports were perceived as being questionable. The available programs also left participants feeling insufficiently prepared to deal with personal mental health problems and in discussing mental health concerns with co-workers. Conclusions—Participants reported needing more engaging methods for delivering information, career-long mental health knowledge acquisition, and a systems approach to improve the workplace culture, particularly regarding mental health.