Title: Traumatic stress and moral injury among first responders during crisis situations
(Stres traumatic și vătămare morală în rândul personalului de intervenție în situații de criză)
Project ID: PN-IV-PCB-RO-MD-2024-0107
Acronym: TSMI_FR
Funding authority: Executive Agency for Higher Education, Research, Development and Innovation Funding (UEFISCDI)
Project budget: 600,000 RON (120000 Euro)
Project timespan: 2025 - 2027
Research Team:
- Cornelia Măirean - Project leader
- Alexandra Cobzeanu - Postdoctoral researcher
- Daniela Muntele – Postdoctoral researcher
- Ovidiu Gavrilovici – Postdoctoral researcher
- Mirabela-Olivia Punei – Doctoral researcher
- Inga Deliv- Postdoctoral Researcher, Team coordinator for State University of Medicine and Pharmacy Nicolae Testemitanu, Republic of Moldova
- Ion Coșciug- Postdoctoral Researcher
- Natalia Caraman- Doctoral researcher
- Mădălina Valache- Doctoral researcher
- Mădălina Bivol- Doctoral researcher
Abstract:
Crisis situations can be related to potentially morally injurious events (PMIE), defined as experiences that may violate an individual’s moral convictions and challenge their anticipated behavior and lead to psychological distress. Under critical situations, people may perpetrate, fail to prevent, or witness events that contradict their core moral beliefs. Exposure to PMIEs can lead to posttraumatic stress and moral injury. Moral injury (MI) is a relatively new area of research that has emerged as an important topic for both research and clinical field over the last decade. Health care workers, including first responders, sometimes have to cope with unfamiliar and very distressing situations, have to make difficult decisions, have to prioritize one set of values over another, have to work under extremely difficult situations, like in the context of different disasters, humanitarian crisis, pandemic, war. The scope of the current research is strengthening the collaboration between Romanian and Republic of Moldova, to facilitate exchange context and to expand the knowledge about moral injury in a less addressed context, of crisis situations and first responders. The concrete objectives are:
- to identify participants’ (i.e., first responders) perception about potentially moral injurious events (PMIE) encountered in their daily activities and their association with mental health indicators (i.e., compassion fatigue and compassion satisfaction);
- to assess the longitudinal relation between PMIE, traumatic stress, and moral injury, during 6 months period, in a sample of first responders;
- to analyze the mediating role of moral distress in the relation between PMIE with traumatic stress and moral injury;
- to identify the moderating role of moral resilience, work mattering, and self-compassion in the relation between PMIE with traumatic stress, and moral injury;
- to identify the relation between traumatic stress, moral injury, and quality of life;
- to assess the effectiveness of interventions based on narrative writing in decreasing moral distress, moral injury and traumatic stress;
- to identify the serial mediating role of moral resilience and moral distress in the relation between traumatic stress and moral injury;
- to create the content of an education program that will be used for designing an workshop addressed to first responders from the two countries, with the general aim to increase the awareness about the risks of their profession for mental health and well-being, and also to promote effective ways to reduce moral injury. The dissemination phase of the project will include presentation of the results in the scientific community through publications in relevant journals and conferences, as well as workshops addressed to community.
Project activities
- Literature review and semi-structured interviews
- Longitudinal trajectory of PMIE, traumatic stress, and moral injury
- Narrative writing intervention
- Dissemination, communication, networking, and exploitation
Expected deliverables:
Synthesis of research results
The semi-structured interview guide
Reports on the results of qualitative analysis
Reports on the results of baseline assessment and on the results of second wave
Reports on the results of baseline assessment, the second wave and follow-up for narrative writing intervention
More than three research papers submitted for publication
Participation at a least three national or international conferences
Two workshops implemented, one in each country
Cognitive and socio-economic impact
The project aims to address critical gaps in the literature by advancing understanding of moral injury among first responders and identifying potentially morally injurious events within medical care contexts. It will examine key protective factors that mitigate the cognitive and psychological risks associated with moral injury, while also generating empirical evidence on the effectiveness of narrative-based interventions in shaping cognitive processing and reducing traumatic stress. Beyond its theoretical contributions, the project has important socio-economic implications, as its findings can inform practitioners in developing evidence-based, cost-effective interventions designed to alleviate moral injury and traumatic stress, ultimately improving resilience and the quality-of-care delivery.