Evidence map›Paper›PMID 42238093›Full record

ArticleFrontiers in psychiatry2026

Cross-disciplinary insights on moral injury conceptualization and care: a qualitative study of expert perspectives.

Falon T Smith, Sarah M Peterson, Maihan B Vu, Melissa A Smigelsky, Sophie A Southerland, Aviva Shira Starr, Jason A Nieuwsma

Abstract read
In one paragraph

Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Falon T Smith *Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, United States.
Sarah M Peterson *Center for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, United States.
Maihan B VuCenter for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, United States.
Melissa A SmigelskyIntegrative Mental Health, Department of Veterans Affairs, Durham, NC, United States.
Sophie A SoutherlandCenter for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, United States.
Aviva Shira StarrCenter for Health Promotion and Disease Prevention, The University of North Carolina, Chapel Hill, NC, United States.
Jason A NieuwsmaIntegrative Mental Health, Department of Veterans Affairs, Durham, NC, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The term "moral injury" has been used to describe moral transgressions and their impact across populations. As a result of this broad application, interpretation of the construct and intervention strategies to address it have become increasingly nuanced and context-specific. This qualitative study explored how subject matter experts working in moral injury research and care across various populations view this complex phenomenon. Methods: Virtual focus group discussions were conducted with 33 researchers, mental health clinicians, and spiritual-care practitioners. Discussions explored the conceptualization of moral injury to inform implications for identification and care. Focus groups were digitally recorded, professionally transcribed, and thematically analyzed using qualitative software. Results: Experts highlighted the context-specific nature of moral injury, where interpretations and applications often vary according to their disciplinary backgrounds and the diversity of populations they serve. Based on their insights and experiences, key themes central to the conceptualization of moral injury and resulting implications for identification and care emerged. Conceptualization of moral injury focused on the development (i.e., progression from moral identity formation and disruption to a maladaptive response to moral pain and distress) and presentation (i.e., distinct features differentiating moral injury from other psychosocial-spiritual constructs). Implications for identification and care centered on the practical value and limitations of broad construct application, diagnostic considerations (e.g., the potential benefits and challenges of pathologizing moral injury), and moral injury-specific intervention and care recommendations, highlighting tailored approaches for addressing the multidimensional nature of moral injury. Discussion: Despite its conceptual complexity, moral injury is a phenomenon that resonates across diverse populations, contributing to its growing recognition and application across professional disciplines. Findings from this study reveal context-specific interpretations and applications of the construct, while also identifying core elements essential for understanding moral injury and informing effective intervention strategies. Overall, findings highlight the evolving, interdisciplinary nature of moral injury and suggest opportunities for tailored and integrative care strategies.

Indexed as

conceptualizationhealthcareintervention strategiesmoral injurypsychological healthqualitative researchveterans

Identifiers

PMID42238093
PMCPMC13226508

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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.