ReviewComprehensive psychoneuroendocrinology2024
The Psychoneuroimmunological Model of Moral Distress and Health in Healthcare Workers: Toward Individual and System-Level Solutions.
Review in Comprehensive psychoneuroendocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 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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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.
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Who cites it
18 citing papers in PubMed.
- Moral distress and moral injury among nurses in German acute inpatient care - a cross-sectional study.BMC nursing · 2026Article
- Workplace Violence in Indonesian Clinical Learning Environments: Cultural and Organisational Contexts Shaping Nursing Students' Experiences.Nursing inquiry · 2026Article
- Health-oriented leadership and health equity: the role of NGO support in advancing public health policy and nutritional literacy.International journal for equity in health · 2026Article
- From Molecules to Meaning: Integrating Neuropeptides, Sociostasis, and Hormesis in the Brain-Heart Axis.Current issues in molecular biology · 2026Review
- Empathy dimensions and patient-centered care during dental training: a cross-sectional study.BMC medical education · 2026Article
- Nurses' experiences of moral suffering: A qualitative interview study.Nursing ethics · 2026Article
- Association between uncertainty stress and self-rated health among Chinese healthcare professionals: a nationwide cross-sectional survey.Frontiers in public health · 2026Article
- Article
- Post-traumatic stress disorder and depression as predictors of peace of mind among healthcare workers working with war victims.Global mental health (Cambridge, England) · 2026Article
- A cross-sectional study investigating optimism and mental resilience among Greek healthcare professionals.Communications medicine · 2025Article
- Data-driven insights into predictors of stress and sleep health among Pakistani healthcare workers under rotational shifts.Scientific reports · 2025Article
- Lifetime stressor exposure is related to suicidality in autistic adults: A multinational study.Autism : the international journal of research and practice · 2025Article
- Navigating Workforce Challenges in Long-Term Care: A Co-Design Approach to Solutions.International journal of environmental research and public health · 2025Article
- Qualitative Exploration of Health Care Professionals' Experiences Caring for Young People With Acute Severe Behavioral Disturbance in the Acute Care Setting.Journal of the American College of Emergency Physicians open · 2025Article
- The positive effect of perceived social support and moral resilience between moral injury and health-related productivity loss among emergency nurses.Frontiers in public health · 2025Article
- Navigating the labyrinth of healthcare workers' mental health.Frontiers in public health · 2025Article
- [Loneliness at the end of life].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2024Review
- Physician Burnout: Designing Strategies Based on Agency and Subgroup Needs [Response to Letter].Journal of healthcare leadership · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Healthcare is presently experiencing a global workforce crisis, marked by the inability of hospitals to retain qualified healthcare workers. Indeed, poor working conditions and staff shortages have contributed to structural collapse and placed a heavy toll on healthcare workers' (HCWs) well-being, with many suffering from stress, exhaustion, demoralization, and burnout. An additional factor driving qualified HCWs away is the repeated experience of moral distress, or the inability to act according to internally held moral values and perceived ethical obligations due to internal and external constraints. Despite general awareness of this crisis, we currently lack an organized understanding of how stress leads to poor health, wellbeing, and performance in healthcare workers. To address this critical issue, we first review the literature on moral distress, stress, and health in HCWs. Second, we summarize the biobehavioral pathways linking occupational and interpersonal stressors to health in this population, focusing on neuroendocrine, immune, genetic, and epigenetic processes. Third, we propose a novel Psychoneuroimmunological Model of Moral Distress and Health in HCWs based on this literature. Finally, we discuss evidence-based individual- and system-level interventions for preventing stress and promoting resilience at work. Throughout this review, we underscore that stress levels in HCWs are a major public health concern, and that a combination of system-level and individual-level interventions are necessary to address preventable health care harm and foster resilience in this population, including new health policies, mental health initiatives, and additional translational research.
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