ArticleInternational journal of environmental research and public health2022
Validation of the German Version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) and Its Correlation to the Second Victim Phenomenon.
Article in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- Presence and detectability of the second victim phenomenon in German-speaking medical professionals involved in dysphagia and respiratory therapy: cross-sectional survey research (SeViD-V).BMC health services research · 2026Article
- Psychometric validation of a cognition and social participation bolt-on for the EQ-5D-5L in SARS-CoV-2 infected German healthcare workers.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- The Swedish moral injury symptoms scale-health professional: psychometric evaluation in a sample of hospital-based healthcare professionals across Sweden.Frontiers in psychology · 2026Article
- Psychometric properties of the Czech moral injury symptom scale.Scientific reports · 2025Article
- Understanding moral injury and its predictors among Chinese physicians.BMC health services research · 2025Article
- The second victim phenomenon in medical education: Development of learning objectives based on the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM).GMS journal for medical education · 2025Review
- Strategies to mitigate moral distress as reported by eldercare professionals.International journal of qualitative studies on health and well-being · 2024Article
- Psychometric evaluation of a Spanish translation of the moral injury symptom scale for healthcare professionals.BMC psychology · 2024Article
- Applicability and Validity of Second Victim Assessment Instruments among General Practitioners and Healthcare Assistants (SEVID-IX Study).Healthcare (Basel, Switzerland) · 2024Article
- Second Victims among Austrian Pediatricians (SeViD-A1 Study).Healthcare (Basel, Switzerland) · 2023Article
- In search of an international multidimensional action plan for second victim support: a narrative review.BMC health services research · 2023Review
- When healers get wounded! Moral injury in healthcare providers during the COVID-19 pandemic in Pakistan.Frontiers in psychiatry · 2023Article
- Self-Assessment and Learning Motivation in the Second Victim Phenomenon.International journal of environmental research and public health · 2022Article
- Understanding Moral Distress among Eldercare Workers: A Scoping Review.International journal of environmental research and public health · 2022Article
- The psychometric properties of the Persian version of the moral injury symptoms scale-health care professionals version.Frontiers in psychology · 2022Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionComparable to second victim phenomenon (SVP), moral injury (MI) affects health professionals (HP) working in stressful environments. Information on how MI and SVP intercorrelate and their part in a psychological trauma complex is limited. We tested and validated a German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) instrument, screening for MI and correlated it with the recently developed German version of the Second Victim Experience and Support Tool (G-SVESTR) instrument, testing for SVP.
methodsAfter translating Moral Injury Symptom and Support Scale for Health Professionals (MISS-HP), we conducted a cross-sectional online survey providing G-MISS-HP and G-SVEST-R to HP. Statistics included Pearson's interitem correlation, reliability analysis, principal axis factoring and principal components analysis with Promax rotation, confirmatory factor and ROC analyses.
resultsA total of 244 persons responded, of whom 156 completed the survey (33% nurses, 16% physicians, 9% geriatric nurses, 7.1% speech and language therapists). Interitem and corrected item-scale correlations did not measure for one item sufficiently. It was, therefore, excluded from further analyses. The nine-item score revealed good reliability (Guttman's lambda 2 = 0.80; Cronbach's alpha = 0.79). Factor validity was demonstrated, indicating that a three-factor model from the original study might better represent the data compared with our two-factor model. Positive correlations between G-MISS-HP and G-SVESTR subscales demonstrated convergent validity. ROC revealed sensitivity of 89% and specificity of 63% for G-MISS-HP using a nine-item scale with cutoff value of 28.5 points. Positive and negative predictive values were 62% and 69%, respectively. Subgroup analyses did not reveal any differences.
conclusionG-MISS-HP with nine items is a valid and reliable testing instrument for moral injury. However, strong intercorrelations of MI and SVP indicate the need for further research on the distinction of these phenomena.
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