ArticleFrontiers in psychiatry2023
Validation of the Moral Injury Outcome Scale in acute care nurses.
Article in Frontiers in psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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Who cites it
5 citing papers in PubMed.
- The Marginalization of Spiritual Dimensions in Nursing Moral Injury Research: A Bibliometric Analysis, 2018-2025.Journal of religion and health · 2026Article
- Moral Injury in the DSM-5-TR: Syndrome Spectrum vs. Categorical Disorder.Journal of religion and health · 2026Article
- Exploring potentially morally injurious events and mental health in a UK representative population.European journal of psychotraumatology · 2025Article
- From Burnout to Resilience: Addressing Moral Injury in Nursing Through Organizational Innovation in the Post-Pandemic Era.Healthcare (Basel, Switzerland) · 2025Review
- Exploring the association between moral injury and posttraumatic stress symptoms among Canadian public safety personnel.Journal of traumatic stress · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Moral injury, predominantly studied in military populations, has garnered increased attention in the healthcare setting, in large part due to the psychological and emotional consequences of the COVID-19 pandemic. The measurement of moral injury with instrumentation adapted from military settings and validated by frontline healthcare personnel is essential to assess prevalence and guide intervention. This study aimed to validate the Moral Injury Outcome Scale (MIOS) in the population of acute care. Methods: A sample of 309 acute care nurses completed surveys regarding moral injury, depression, anxiety, burnout, professional fulfillment, spiritual wellbeing, and post-traumatic stress disorder symptoms. Confirmatory factor analysis was conducted as well as an assessment of reliability and validity. Results: The internal consistency of the 14-item MIOS was 0.89. The scale demonstrated significant convergent and discriminant validity, and the test of construct validity confirmed the two-factor structure of shame and trust violations in this clinical population. Regression analysis indicated age, race, and marital status-related differences in the experience of moral injury. Discussion: The MIOS is valid and reliable in acute care nursing populations and demonstrates sound psychometric properties. Scores among nurses diverge from those of military personnel in areas that may inform distinctions in interventions to address moral injury in these populations.
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