Toward a Dimensional Contextual Model of Moral Injury: A Scoping Review on Healthcare Workers

Current Treatment Options in Psychiatry, Год журнала: 2023, Номер 10(3), С. 199 - 216

Опубликована: Июль 4, 2023

Abstract Purpose of Review Healthcare workers (HCWs) may be exposed to potentially morally injurious events (PMIEs) while on the job and consequently experience acute, functional moral distress prolonged, impairing injury. Recent Findings We reviewed 185 articles and/or injury among HCWs. This included 91 empirical studies (approximately 50% retained articles), 68 editorials (37%), 18 reviews (10%), 8 protocol papers (4%). Themes were explored using bibliometric network analysis keyword co-citation. Empirical found evidence PMIE exposure a considerable proportion Greater severity was associated with worse mental occupational health outcomes, especially women (vs. men), younger HCWs older), nurses physicians), those who worked more hours, less experience. Programs prevent treat lack evidence. Summary Efforts maintain well-being effectiveness should consider potential impact To that end, we introduce dimensional contextual model in healthcare settings discuss recommendations for prevention treatment.

Язык: Английский

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The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic

European journal of psychotraumatology, Год журнала: 2024, Номер 15(1)

Опубликована: Фев. 9, 2024

Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied healthcare contexts. Distress (MD), a related concept, may enhance understandings MI and its relation to among HCWs. This study examined independent combined impact MD on Canadian HCWs

Язык: Английский

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The impact of moral injury on healthcare workers’ career calling: exploring authentic self-expression, ethical leadership, and self-compassion

BMC Medical Ethics, Год журнала: 2025, Номер 26(1)

Опубликована: Янв. 31, 2025

Moral injury is a significant issue for healthcare workers, often stemming from exposure to ethical dilemmas and distressing events. This study aims explore the relationship between moral workers' career calling, using job demands-resources model as theoretical framework. The goal understand how affects sense of purpose vocation identify factors that may mitigate this impact. A cross-sectional survey was conducted with sample 506 Chinese workers. used self-report questionnaires assess injury, authentic self-expression, self-compassion, leadership, calling. Path analysis test proposed mediating moderating relationships within model. has negative effect on mediated by self-expression - inability openly discuss distress weakens purpose. Self-compassion leadership buffer against impact research contributes understanding calling in practical implications safeguarding professionals' well-being commitment their vocation.

Язык: Английский

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Exploration of Nurses' Experiences Related to Moral Injury: A Reflexive Thematic Analysis of Nurse Interviews

Journal of Advanced Nursing, Год журнала: 2025, Номер unknown

Опубликована: Фев. 26, 2025

ABSTRACT Aim To provide a description of nurses' experiences related to moral injury, including Potentially Morally Injurious Events and factors the impact those events. Design Reflexive thematic analysis nurse interviews. Method Nurses were recruited from an ongoing study within large academic medical centre. who enrolled in present participated semi‐structured individual interviews using interview guide based on Litz's conceptualisation injury. Themes identified recorded transcribed Results Interviews conducted with 12 nurses May June 2023 coded for themes three broad categories: (a) Nursing Values, (b) Experiences (c) Stressors Supports. Within these categories, we pinpointed 8 3 subthemes, which highlight experience potentially morally injurious events challenging care, strained relationships physicians, treatment inequity, conflict their nursing values. We team organisational factors, senior leadership behaviours, dynamics access resources that appear intensify or lessen Conclusion contribute occupational stress experienced by nurses, particularly when systemic demands prevent them providing value‐driven ethically necessary healthcare. Limiting supportive environments following stressors requires organisational‐level changes healthcare alleviate stress. Impact This research highlights need organisations implement interventions aimed both at reducing creating system team‐level supports unavoidable These results pinpoint specific areas prevention, intervention support. Patient Public Contribution No Contribution.

Язык: Английский

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Measuring moral distress in Swedish intensive care: Psychometric and descriptive results

Intensive and Critical Care Nursing, Год журнала: 2023, Номер 76, С. 103376 - 103376

Опубликована: Янв. 25, 2023

To investigate the construct validity and psychometric properties of Swedish version Moral Distress Scale-Revised to describe moral distress in an intensive care context.The Italian was translated semantically adjusted context. A web survey with 14 items, as well three additional eight background questions answered by critical nurses (N = 71) working units during second year coronavirus disease pandemic. Inferential descriptive statistics were used four-factor model examine nurses' distress.The result shows a factor four components differing from previous model. Critical demonstrated significant differences regarding priorities compared before pandemic, type household; experience whether they had supervised students pandemic.The component structure might have originated specific situation perceived The health organisations' role preventing healing effects is important for managers understand.Moral common it necessary use valid instrument when measuring it. psychometrical investigation Scale-Revised, adapted need further semantic cultural adaptation. Perceived household type, supervising pandemic related be aware conditions that may trigger such response.

Язык: Английский

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Moral distress and moral injury and their interplay as a challenge for leadership and management: The case of Croatia

Journal of Nursing Management, Год журнала: 2022, Номер 30(7), С. 2335 - 2345

Опубликована: Окт. 1, 2022

Aim We aim to investigate the interplay between moral distress and injury among nurses working in palliative oncology wards assess its impact on nursing leadership. Background The past 2 years have been particularly challenging for leaders Croatia. coronavirus disease pandemic subsequent earthquakes country significantly impacted work of nurses. Moral has well-known professionals, but recent studies warn about cofounding it with their possible intercorrelation, deserving more attention from an empirical perspective. Methods conducted quantitative cross-sectional research 11 Croatian health care facilities 162 nurses, using a questionnaire paper/pencil method over 6 months (1 January 2021 1 July 2021). consisted three parts: sociodemographic data, Measure professionals symptoms scale professionals. protocol was approved by Ethics committee Catholic University Croatia under no. 1-21-04. Results findings our study demonstrated that current average levels might be characterized as low, are severe. results bring interesting novel insights, such strong correlation injury, also terms nurses' decision leave or consider leaving position. who experience higher severe while score left, considered positions. Conclusions This highlighted need pay emerging phenomenon unaddressed overshadowed distress, importance addressing them timely adequately within organizations leadership management. Implications Nursing Management These provide significant insight may assist managers act respond time develop various prevention mitigation measures help resolve situations leading injury.

Язык: Английский

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Past, Present, and Future of Cognitive Behavioral-based Psychotherapies for Moral Injury

Current Treatment Options in Psychiatry, Год журнала: 2024, Номер unknown

Опубликована: Авг. 30, 2024

Язык: Английский

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Properties of the modified self‐forgiveness dual‐process scale in populations at risk for moral injury

Stress and Health, Год журнала: 2024, Номер 40(5)

Опубликована: Май 10, 2024

Abstract Despite theory suggesting that self‐forgiveness facilitates recovery from moral injury, no measure of has been validated with individuals exposed to potentially morally injurious events (PMIEs). Military veterans, healthcare workers, and first responders who reported PMIE exposure ( n = 924) completed the Self‐Forgiveness Dual‐Process Scale, which assesses two dimensions process. The dimension, value affirmation, refers appraising personal responsibility being willing make amends for one's involvement in a PMIE. second esteem restoration, accepting oneself as valuable capable growth despite failures imperfections. Exploratory Confirmatory Factor Analyses replicated original scale's two‐factor structure 10 items modified apply diverse contexts PMIEs occur. Next, we found factor structure, item loadings, intercepts were fully or partially invariant across professions, genders, races, ages, religious affiliations series Multi‐Group Analyses. Finally, diverging patterns associations between affirmation restoration distress, posttraumatic stress, depression, insomnia, functional impairment, provide evidence convergent discriminant validity subscales. dual process scale is be Researchers clinicians can use examine how (or difficulties forgiving oneself) relates injury.

Язык: Английский

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Moral Injury for LGBTQ+ Individuals and their Communities

Current Treatment Options in Psychiatry, Год журнала: 2024, Номер unknown

Опубликована: Окт. 3, 2024

Язык: Английский

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Moral Injury and Nursing Practice

Опубликована: Янв. 1, 2024

Язык: Английский

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