Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts.
Providence VA Medical Center, Providence, Rhode Island.
J Clin Psychol. 2018 Dec;74(12):2203-2218. doi: 10.1002/jclp.22660. Epub 2018 Jul 9.
Service members deployed to war are at risk for moral injury, but the potential sources of moral injury are poorly understood. The aim of this qualitative study was to explore the types of events that veterans perceive as morally injurious and to use those events to develop a categorization scheme for combat-related morally injurious events.
Six focus groups with US war veterans were conducted.
Analysis based on Grounded Theory yielded two categories (and eight subcategories) of events that putatively cause moral injury. The two categories were defined by the focal attribution of responsibility for the event: Personal Responsibility (veteran's reported distress is related to his own behavior) versus Responsibility of Others (veteran's distress is related to actions taken by others). Examples of each type of morally injurious event are provided.
Implications for the further development of the moral injury construct and treatment are discussed.
部署到战争中的军人面临道德伤害的风险，但对道德伤害的潜在来源知之甚少。本定性研究的目的是探讨退伍军人认为道德伤害的事件类型，并使用这些事件为与战斗相关的道德伤害事件制定分类方案。
对美国退伍军人进行了六组焦点小组讨论。
基于扎根理论的分析产生了两个潜在导致道德伤害的事件类别（八个子类）。这两个类别是根据事件的责任焦点来定义的：个人责任（退伍军人报告的痛苦与他自己的行为有关）与他人责任（退伍军人的痛苦与他人的行为有关）。提供了每一种类型的道德伤害事件的例子。
讨论了对道德伤害结构和治疗的进一步发展的影响。
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