Evidence map›Paper›PMID 40008669›Full record

ArticleJournal of advanced nursing2025

Exploration of Nurses' Experiences Related to Moral Injury: A Reflexive Thematic Analysis of Nurse Interviews.

Mindy J Vanderloo, Ethan Evans, Andrew Smith, Megan Call, Amy Locke, Hannah Wright, Karen W Tao

Abstract read
In one paragraph

Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mindy J VanderlooResiliency Center, University of Utah Health, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0003-3521-0481
Ethan EvansResiliency Center, University of Utah Health, Salt Lake City, Utah, USA.
Andrew SmithGeisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Megan CallResiliency Center, University of Utah Health, Salt Lake City, Utah, USA.
Amy LockeResiliency Center, University of Utah Health, Salt Lake City, Utah, USA.
Hannah WrightUniversity of Utah, Huntsman Mental Health Institute, Salt Lake City, Utah, USA.
Karen W TaoDepartment of Educational Psychology, University of Utah, Salt Lake City, Utah, USA.

Funding

Bureau of Health Workforce 1 U3MHP45388-01-00
6 · The paper itself

Abstract

aimTo provide a description of nurses' experiences related to moral injury, including Potentially Morally Injurious Events and factors related to the impact of those events.

designReflexive thematic analysis of nurse interviews.

methodNurses were recruited from an ongoing study within a large academic medical centre. Nurses who enrolled in the present study participated in semi-structured individual interviews using an interview guide based on Litz's conceptualisation of moral injury. Themes were identified in the recorded and transcribed interviews.

resultsInterviews were conducted with 12 nurses in May and June 2023 and coded for themes within three broad categories: (a) Nursing Values, (b) Experiences of Potentially Morally Injurious Events and (c) Stressors and Supports. Within these categories, we pinpointed 8 themes and 3 subthemes, which highlight the nurses experience of potentially morally injurious events related to challenging care, strained relationships with physicians, and treatment inequity, which conflict with their nursing values. We identified team and organisational factors, including senior leadership behaviours, team dynamics and access to resources that appear to intensify or lessen the impact of these events.

conclusionPotentially Morally Injurious Events contribute to the occupational stress experienced by nurses, particularly when systemic organisational factors and demands prevent them from providing the value-driven and ethically necessary healthcare. Limiting Potentially Morally Injurious Events and providing supportive environments following stressors requires organisational-level changes within healthcare environments to prevent and alleviate nurses' occupational stress. IMPACT: This research highlights the need for healthcare organisations to implement systemic interventions aimed both at reducing Potentially Morally Injurious Events and creating system and team-level supports to lessen the impact of unavoidable events. These results pinpoint specific areas for prevention, intervention and support. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Indexed as

MoralsNursing Staff, HospitalOccupational StressAdultAttitude of Health PersonnelFemaleHumansInterviews as TopicMaleMiddle AgedQualitative Researchhealthcare professionalsmoral distressmoral injuryoccupational stressregistered nurses

Identifiers

PMID40008669
PMCPMC12460941

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.