Background: Compassion fatigue and professional quality of life are important in health and professional ethics. Aim: This study aimed to determine the relationship between compassion satisfaction, compassion fatigue, secondary traumatic stress, and moral injury in nurses. Research design: This research is a cross-sectional descriptive-analytical study. The research community of this research was all the nurses of the teaching hospitals of Ardabil city. Three questionnaires on demographic characteristics, the Professional Quality of Life Scale (ProQOL), and the Moral Injury Events Scale were (...) used to collect data. SPSS (version 22) software was used for data analysis. Participants and research context: The study recruited 297 nurses randomly selected from five teaching hospitals in Ardabil city. Ethical considerations: Ethical approval was obtained from the Ardabil University of Medical Sciences ethics committee (with the code of ethics IR.ARUMS.REC.1401.198). Informed consent was obtained from the participants. Results: The results showed that the mean compassion satisfaction score of this study’s participants was 37.61 ± 8.86, the mean compassion fatigue score of this study’s participants was 28.73 ± 7.04, and the mean secondary traumatic stress score of this study’s participants was 29.95 ± 7.84. The mean score of moral injury among nurses was 31.19 ± 8.54. The results showed a negative significant relationship between compassion satisfaction and moral injury ( p < 0.001). Also, there is a positive significant relationship between compassion fatigue and secondary traumatic stress with moral injury ( p < 0.001). Conclusion: The results of this study show a negative relationship between compassion satisfaction and moral injury. According to the results of the present study, nurse managers should implement educational interventions, create ethical processes, and clear ethical guidelines to reduce moral injury and increase compassion satisfaction. (shrink)

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...) context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration. (shrink)

After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything. The current research seeks to develop the construct of moral injury outside military contexts, (...) generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics. There are no data in this work. (shrink)

Das Thema „moralischer Stress / moralische Verletzung“ hat als Gegenstand der sozialwisschenschaftlichen, psychologischen und auch ethischen Forschung in den letzten Jahren an Bedeutung gewonnen. Dieses Kapitel stellt dar, was unter diesen Begriffen zu verstehen ist. Anhand ausgewählter Berufsfelder wird die Problematik und die Praxisrelevanz dieses Forschungsbereichs aus ethischer Perspektive dargestellt. Ansatzweise werden zwei Aspekte angesprochen, die bei der Prävention bzw. Heilung von moralischen Verletzungen hilfreich sein könnten, gleichwohl weiterer Forschung bedürfen: Ein philosophisch fundierter Begriff von „Vertrauen“ und die Relevanz von (...) „Ethiklehre“ in der (akademischen) Berufsausbildung. (shrink)

Ethik und Seelsorge sind Bereiche, in denen menschliches Sein und Handeln reflektierend begleitet wird, um Orientierung, Unterstützung oder Trost zu geben. Bei Berufen, in denen Menschen auf eine gewaltverstrickte Lebenswelt treffen, ihrerseits staatlich legitimiert Gewalt ausüben und selbst von Gewalt betroffen sind, tauchen dabei besondere Widersprüche und Sinnfragen auf. Diese Herausforderungen in den Blick zu nehmen und an der Schnittstelle von Philosophie und praktischer Theologie zu erörtern, so wie es der Münsteraner Theologe Werner Schiewek richtungsweisend vorgezeichnet hat, ist das Ziel (...) des vorliegenden Bandes. (shrink)