ArticlePloS one2021
A longitudinal analysis of the role of potentially morally injurious events on COVID-19-related psychosocial functioning among healthcare providers.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07710521 (Comparing Two Moral Injury Treatments), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Comparing Two Moral Injury Treatments: Acceptance and Commitment Therapy for Moral Injury and Present Centered Therapy for Moral Injury
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- Guilt, Not Shame, Mediates the Longitudinal Relationship Between Moral Distress and Suicidal Ideation Among Frontline Nurses During COVID-19.Journal of clinical psychology · 2026Article
- Qualitative insights into nurses' emotional and functional experiences in the 2023 military humanitarian mission to Turkey.Israel journal of health policy research · 2026Article
- Exploring potentially morally injurious events and mental health in a UK representative population.European journal of psychotraumatology · 2025Article
- Examining Moral Injury in Legal-Involved Veterans: Psychometric Properties of the Moral Injury Events Scale.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Article
- A mixed-methods analysis of moral injury among healthcare workers during the COVID-19 pandemic.PloS one · 2024Article
- Light Personality Style and Moral Injury Among Chinese Health Professionals.Journal of religion and health · 2023Article
- Influence of spirituality on moral distress and resilience in critical care staff: A scoping review.Intensive & critical care nursing · 2023Article
- The Hidden Crisis: Understanding Potentially Morally Injurious Events Experienced by Healthcare Providers during COVID-19 in Canada.International journal of environmental research and public health · 2023Article
- The Long Tail of COVID-19: Implications for the Future of Emergency Nursing.Journal of emergency nursing · 2023Article
- Validation of the Moral Injury Outcome Scale in acute care nurses.Frontiers in psychiatry · 2023Article
- When healers get wounded! Moral injury in healthcare providers during the COVID-19 pandemic in Pakistan.Frontiers in psychiatry · 2023Article
- Critical Care Providers' Moral Distress: Frequency, Burden, and Potential Resources.International journal of environmental research and public health · 2022Article
- Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses' Occupational Wellbeing: A Cross-Sectional Experimental Study.International journal of environmental research and public health · 2022Article
- Injurious Memories from the COVID-19 Frontline: The Impact of Episodic Memories of Self- and Other-Potentially Morally Injurious Events on Romanian Nurses' Burnout, Turnover Intentions and Basic Need Satisfaction.International journal of environmental research and public health · 2022Article
- The Moral Impact of the COVID-19 Pandemic on Nurses' Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic Psychological Needs.International journal of environmental research and public health · 2022Article
- Moral Injury and Recovery in Uniformed Professionals: Lessons From Conversations Among International Students and Experts.Frontiers in psychiatry · 2022Article
- The Role of Social Determinants of Health in Moral Injury: Implications and Future Directions.Current treatment options in psychiatry · 2022Review
- Research Gaps and Recommendations to Guide Research on Assessment, Prevention, and Treatment of Moral Injury Among Healthcare Workers.Frontiers in psychiatry · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Medical leaders have warned of the potential public health burden of a "parallel pandemic" faced by healthcare workers during the COVID-19 pandemic. These individuals may have experienced scenarios in which their moral code was violated resulting in potentially morally injurious events (PMIEs). In the present study, hierarchical linear modeling was utilized to examine the role of PMIEs on COVID-19 pandemic-related difficulties in psychosocial functioning among 211 healthcare providers (83% female, 89% White, and an average of 11.30 years in their healthcare profession [9.31]) over a 10-month span (May 2020 -March 2021). Reported exposure to PMIEs was associated with statistically significant poorer self-reported psychosocial functioning at baseline and over the course of 10-months of data collection. Within exploratory examinations of PMIE type, perceptions of transgressions by self or others (e.g., "I acted in ways that violated my own moral code or values"), but not perceived betrayal (e.g., "I feel betrayed by leaders who I once trusted"), was associated with poorer COVID-19 related psychosocial functioning (e.g., feeling connected to others, relationship with spouse or partner). Findings from this study speak to the importance of investing in intervention and prevention efforts to mitigate the consequences of exposure to PMIEs among healthcare providers. Interventions for healthcare providers targeting psychosocial functioning in the context of moral injury is an important area for future research.
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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.