JMIR Publications

ABSTRACT

Background:

Stress, anxiety, distress and depression are high among healthcare workers during the COVID-19 pandemic and they have reported acting in ways that are contrary to their moral values, integrity, and professional commitments that degrade their integrity. This creates moral distress and injury as a result of constraints they have encountered, such as limited resources.

Objective:

The purpose of this study is to develop and show feasibility of digital platform (Virtual Reality (VR) and mobile platform) to understand the causes and ultimately reduce the moral distress of healthcare providers during the COVID-19 pandemic. This project is a proof-of-concept integration of concepts/applications to demonstrate viability over six months and serve as a guide for future studies to develop these state-of-the-art technologies to help frontline healthcare workers work in complex moral contexts. The project will develop innovations which can be used for future pandemics and in other contexts prone to producing moral distress and injury.

Methods:

This will be a prospective, single cohort, pre- and post-test study examining the effect of brief informative video describing moral distress on perceptual, psychological, and physiological indicators of stress and decision-making during the scenario known to potentially elicit moral distress. To accomplish this, we have developed a VR simulation scenario that will be used before and after the digital intervention for monitoring of short-term impacts. The simulation involves an ICU setting during the COVID-19 pandemic and participants will be placed in a morally challenging situation, the participants will be engaged at the individual, team, and organizational levels. During each test, data will be collected for a) physiological measures of stress and after each test, data will be collected regarding b) thoughts, feelings and behaviors during a morally challenging situation, and c) perceptual estimates of psychological stress. We aim to create an effective compound intervention that is composed of the VR-based simulation educational intervention that is verified through the data collection of mental health questionnaires. In addition, participants will continue to be monitored for moral distress and other psychological stresses for 8 weeks through our Digital intervention/intelligence Group mobile (DiiG) platform for longer-term impact. A baseline comparison will be conducted using machine learning and statistical techniques to analyze the short- and long-term impacts of the VR intervention.

Results:

Funded in (November, 2020), approved by REB in (March, 2021), study is ongoing.

Conclusions:

This project aims to demonstrate the feasibility of using digital platforms to understand the continuum of moral distress that can lead to moral injury. Demonstration of feasibility will lead to future studies to examine the efficacy of digital platforms to reduce moral distress. Clinical Trial: Trial registry name: ClinicalTrials.gov Registration/identifier number: NCT05001542 URL: https://clinicaltrials.gov/ct2/show/NCT05001542