ArticleNursing ethics2021
Self-care strategies in response to nurses' moral injury during COVID-19 pandemic.
Article in Nursing ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04890665 (Effectiveness of a Self-applied Multi-component Psychological Online Intervention Based on User Experience, for Anxiety, Depression, Burnout, Fatigue Compassion on Healthcare Workers During the COVID-19 Outbreak), which is not on this map. Cited by 113 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of a Self-applied Multi-component Psychological Online Intervention Based on User Experience, for Anxiety, Depression, Burnout, Fatigue Compassion on Healthcare Workers During the COVID-19 Outbreak: A Randomized Clinical Trial
Who cites it
113 citing papers in PubMed, 2 syntheses or guidelines pooled it, 275 citations in OpenAlex.
- The Association of Moral Injury and Healthcare Clinicians' Wellbeing: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- COVID-19 pandemic effects on health worker's mental health: Systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2022Pooled it
- The Marginalization of Spiritual Dimensions in Nursing Moral Injury Research: A Bibliometric Analysis, 2018-2025.Journal of religion and health · 2026Article
- Trends and Thematic Clusters in Moral Injury Research: A Bibliometric Analysis.Journal of religion and health · 2026Article
- Guilt, Not Shame, Mediates the Longitudinal Relationship Between Moral Distress and Suicidal Ideation Among Frontline Nurses During COVID-19.Journal of clinical psychology · 2026Article
- 'The Bird Fights Its Way Out of the Egg': A Phenomenological Study of Nurses' Lived Experiences of Self-Care in South Korea's Closed Psychiatric Wards.Healthcare (Basel, Switzerland) · 2026Article
- Support for the wellbeing of frontline healthcare workers should be incorporated in health emergency preparedness planning.Communications medicine · 2026Review
- The influence of contextual factors on the sustainability of the family talk intervention after implementation when a parent of children or youths has a life-threatening illness.Palliative & supportive care · 2025Article
- Attitude and "Self-Compassion and Purpose" as Factors Influencing Nurses' Intentions to Engage in Mindful Self-care in the Perianesthesia Setting.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2025Article
- Alone on an Island: Experiences and Needs of Intensive Care Unit Nurses During the COVID-19 Pandemic: A Focused Ethnography.Nursing open · 2025Article
- Mediating effect of moral resilience between good-death perception and coping with death competence of ICU nurses: a cross-sectional study.BMC nursing · 2025Article
- Supervision, Moral Distress and Moral Injury Within Palliative Care-A Qualitative Study.International journal of environmental research and public health · 2025Article
- Secondary stressors and their psychosocial impacts on healthcare staff: lessons from a qualitative systematic review from the COVID-19 pandemic in the UK.BJPsych open · 2025Review
- Moral injury and its effects on academic performance of student nurses in South Africa.Curationis · 2025Article
- Understanding moral injury and its predictors among Chinese physicians.BMC health services research · 2025Article
- Second victim syndrome among nursing professionals as a result of COVID-19: qualitative research.BMC nursing · 2025Article
- Visualising the voices of nursing: a co-designed video capturing the lived experiences of nurses in Northern Ireland during the COVID-19 pandemic.BMC nursing · 2025Article
- Prevalence of Anxiety and Depression among Nurses during the early phase of COVID-19: A meta-analysis.Pakistan journal of medical sciences · 2025Review
- Sleep disorders among frontline nurses after the COVID-19 outbreak: a large-scale cross-sectional study.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- The serial mediating effects of moral resilience and moral courage on the relationship between moral injury and positive coping style in Chinese nursing interns.Frontiers in psychology · 2025Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
These are strange and unprecedented times in the wake of the COVID-19 pandemic. Most frontline healthcare professionals have never witnessed anything like this before. As a result, staff may experience numerous and continuous traumatic events, which in many instances, will negatively affect their psychological well-being. Particularly, nurses face extraordinary challenges in response to shifting protocols, triage, shortages of resources, and the astonishing numbers of patients who require care in expedited time constraints. As most healthcare workers are passionate nursing professionals, frustration and often a sense of powerlessness occur when they find themselves unable to provide needed care to their patients. The overwhelming number of deaths, patients isolated and dying alone, and the ever-present fear of being infected and then infecting colleagues, family, friends due to the lack of protective gear or known protocols takes its toll on emotional and psychological well-being. For nurses, the experience of this significant (hopefully once-in-a-lifetime) event can inflict on-going moral injury. Nurses affected by this trauma require education, coping tools, and therapy to help avoid or alleviate the adverse effects on their well-being. Institutions must provide these resources to tend to the well-being of their healthcare staff, during and beyond the pandemic. This article aims to investigate moral distress-considering it as a moral injury-and offer tools and recommendations to support healthcare nurses as they respond to this crisis and its aftermath.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.