Measuring moral distress and moral injury: A systematic review and content analysis of existing scales.

Autor:	Houle SA; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Research Directorate, Veterans Affairs Canada, Charlottetown, Canada., Ein N; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada., Gervasio J; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada., Plouffe RA; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychology, University of Dundee, Dundee, UK., Litz BT; Department of Psychiatry, Boston University, Boston, USA; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, USA; Department of Psychological and Brain Sciences, Boston University, Boston, USA., Carleton RN; Department of Psychology, University of Regina, Regina, Canada., Hansen KT; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada., Liu JJW; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada., Ashbaugh AR; School of Psychology, University of Ottawa, Ottawa, Canada., Callaghan W; Department of Anthropology, University of Toronto, Toronto, Canada., Thompson MM; Defence Research and Development Canada, Toronto, Canada., Easterbrook B; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada., Smith-MacDonald L; St. Stephens College, University of Alberta, Edmonton, Canada., Rodrigues S; The Atlas Institute for Veterans and Families, Ottawa, Canada., Bélanger SAH; Royal Military College of Canada, Kingston, Canada., Bright K; Nursing and Midwifery, Mount Royal University, Calgary, Canada., Lanius RA; Department of Psychiatry, Western University, London, Canada., Baker C; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada., Younger W; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada., Bremault-Phillips S; Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada., Hosseiny F; The Atlas Institute for Veterans and Families, Ottawa, Canada., Richardson JD; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada; St. Joseph's Operational Stress Injury Clinic, St. Joseph's Health Care London, London, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada., Nazarov A; MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada. Electronic address: anthony.nazarov@sjhc.london.on.ca.
Jazyk:	angličtina
Zdroj:	Clinical psychology review [Clin Psychol Rev] 2024 Mar; Vol. 108, pp. 102377. Date of Electronic Publication: 2023 Dec 27.
DOI:	10.1016/j.cpr.2023.102377
Abstrakt:	Background: Moral distress (MD) and moral injury (MI) are related constructs describing the negative consequences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. Method: We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific outcomes measured by each scale. Results: We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes. Conclusions: Results show how the terms MD and MI are applied in research. Several scales were identified as appropriate for research and clinical use. Recommendations for the application, development, and validation of MD and MI scales are provided. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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