Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO 80210, USA.
Int J Environ Res Public Health. 2023 Jul 5;20(13):6300. doi: 10.3390/ijerph20136300.
Research focused on elucidating moral injury amongst healthcare workers (HCWs) is essential due to the deep connection with morality and individuals' overall wellbeing. Examining moral injury provides an avenue through which researchers can connect individual experiences with systemic level causes (i.e., structural power imbalances between clinicians and health systems) to better study workplace wellbeing. The omnipresence of the COVID-19 pandemic has amplified the need to study moral injury. This paper describes a systematic review conducted using PRISMA-P guidelines to answer the question, "what is the association between moral injury and professional wellbeing and mental health amongst healthcare workers." Twelve databases were searched to identify specified studies. This study's criteria included: (1) articles published through December 2022; (2) qualitative and quantitative empirical studies; (3) articles written in English; (4) articles including moral injury; and (5) articles including at minimum one other measure of professional or personal wellbeing. The initial search produced 248 articles, and 18 articles were ultimately included in the final review. To confirm that no articles were left out of this study, the first author of each included article was contacted to inquire about any additional works that met the inclusion criteria of this study. The elements of the 18 included articles described in this review are discussed. The results indicate that moral injury is associated with both professional wellbeing factors and mental health outcomes. Further theoretical development, including (professional- and identity-based) exploratory research on moral injury, and evidenced-based interventions for moral injury are needed.
研究医护人员（HCWs）的道德伤害问题至关重要，因为这与道德和个人整体福祉密切相关。研究道德伤害为研究人员提供了一个途径，可以将个体经验与系统层面的原因（即临床医生和医疗体系之间的结构性权力失衡）联系起来，从而更好地研究工作场所的幸福感。COVID-19 大流行的普遍存在加剧了研究道德伤害的必要性。本文描述了一项使用 PRISMA-P 指南进行的系统评价，以回答“道德伤害与医护人员的专业幸福感和心理健康之间有什么关联”的问题。为了识别特定的研究，我们检索了 12 个数据库。该研究的标准包括：（1）发表于 2022 年 12 月之前的文章；（2）定性和定量实证研究；（3）用英语撰写的文章；（4）包含道德伤害的文章；（5）至少包含一项其他专业或个人幸福感衡量标准的文章。最初的搜索产生了 248 篇文章，最终有 18 篇文章被纳入最终的综述。为了确认本研究没有遗漏任何文章，我们联系了每篇纳入文章的第一作者，询问是否有任何其他符合本研究纳入标准的作品。本文讨论了综述中所包含的 18 篇文章的要素。结果表明，道德伤害与专业幸福感因素和心理健康结果都有关联。需要进一步进行理论发展，包括对道德伤害的（基于职业和身份的）探索性研究，以及基于证据的道德伤害干预措施。
