Psychometric properties of the Turkish Version of The Moral Injury Symptom Scale: Healthcare Professionals Version

Üstün, Gonca

doi:10.14744/phd.2021.34603

Cited by 5 publications

(5 citation statements)

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“…This is an important finding because it indicates that although most of them might experience low levels of distress, the majority might suffer from severe levels of moral injury that might end unrecognized. In our CFA analysis, we confirmed three factors for MISS‐HP as presented by Mantri et al (2020) and later confirmed in other studies as well (Mantri et al, 2021; Trifunovic‐Koenig et al, 2022; Üstün, 2022; Zhizhong et al, 2020). It is noteworthy to consider that such higher levels of moral injury can also be attributed to the ongoing COVID‐19 pandemic and earthquake experience.…”

Section: Discussionsupporting

confidence: 89%

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

Stanojević

Čartolovni

2022

J Nursing Management

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

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Section: Discussionsupporting

confidence: 89%

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

Stanojević

Čartolovni

2022

J Nursing Management

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“…a higher percentage of nurses within the samples were associated with a more significant association between MI and anxiety and depressive symptoms. Nurses have close contact with patients and spend considerable time with them and their relatives (Üstün, 2022 ). Thus, nurses may be particularly vulnerable to potentially morally injurious events and may have witnessed difficult ethical situations more often throughout the pandemic (Williamson et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis

Coimbra,

Zylberstajn,

van Zuiden

et al. 2024

European Journal of Psychotraumatology

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Background : During the COVID-19 pandemic, health-care workers (HCWs) may have been confronted with situations that may culminate in moral injury (MI). MI is the psychological distress that may result from perpetrating or witnessing actions that violate one’s moral codes. Literature suggests that MI can be associated with mental health problems. Objective : We aimed to meta-analytically review the literature to investigate whether MI is associated with symptoms of posttraumatic stress disorder (PTSD), anxiety, depression, burnout, and suicidal ideation among active HCWs during the COVID-19 pandemic. Method : We searched eight databases for studies conducted after the onset of the COVID-19 pandemic up to 18 July 2023, and performed random-effects meta-analyses to examine the relationship between MI and various mental health outcomes. Results : We retrieved 33 studies from 13 countries, representing 31,849 individuals, and pooled 79 effect sizes. We found a positive association between MI and all investigated mental health problems ( r s = .30–.41, all p s < .0001). Between-studies heterogeneity was significant. A higher percentage of nurses in the samples was associated with a stronger relationship between MI and depressive and anxiety symptoms. Samples with a higher percentage of HCWs providing direct care to patients with COVID-19 exhibited a smaller effect between MI and depressive and anxiety symptoms. We observed a stronger effect between MI and PTSD symptoms in US samples compared to non-US samples. Conclusion : We found that higher MI is moderately associated with symptoms of PTSD, anxiety, depression, burnout, and suicidal ideation among HCWs during the COVID-19 pandemic. Our findings carry limitations due to the array of MI scales employed, several of which were not specifically designed for HCWs, but underscore the need to mitigate the effect of potentially morally injurious events on the mental health of HCWs.

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“…10 The MISS-HP contains a mix of positively and negatively worded items to reduce response bias, and it has a strong evidence base in the literature. [10][11][12][13][14] We stored responses in a secure REDCap® drive, accessible only to IRB-approved study members, to ensure anonymity.…”

Section: Methodsmentioning

confidence: 99%

Moral Injury among Transplant Providers: Evaluating the Effects of Training in End-of-Life Counseling

David,

Rosell,

Hughes

2023

kjm

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Introduction. Ethical issues are pervasive in healthcare, but few specialties rival the moral complexity of transplant medicine. Transplant providers must regularly inform patients that they are no longer eligible to receive a potentially life-saving operation and the stress of these conversations poses a high risk of moral injury. Training in end of life counseling (EOLC) has been shown to significantly reduce provider stress and burnout. We hypothesized that training in EOLC reduces levels of moral injury among transplant providers. Methods. This was a mixed methods study. A survey was administered to staff in the solid organ transplant department at the University of Kansas Health System. Providers indicated whether they had received training in EOLC and completed the standardized Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). A two-sample, one-sided t-test compared levels of moral injury between trained and untrained staff. Subsequently, semi-structured interviews were conducted with transplant providers, and inductive coding followed by thematic network analysis was performed. Results. Thirty-seven percent of respondents reported a moral injury score at or above the threshold for psychosocial dysfunctioning associated with moral injury. Analysis revealed no difference in moral injury scores between the trained and untrained groups (p=0.362, power=0.842). Ten participants were interviewed. Thematic network analysis demonstrated high-level themes of “challenges”, “training” and “stress relief”. Conclusions. Our study demonstrated a concerning prevalence of moral injury among transplant providers and suggested that EOLC training does not significantly mitigate the threat of moral injury.

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Psychometric properties of the Turkish Version of The Moral Injury Symptom Scale: Healthcare Professionals Version

Cited by 5 publications

References 0 publications

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

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

Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis

Moral Injury among Transplant Providers: Evaluating the Effects of Training in End-of-Life Counseling

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