A Systematic Review and Meta-Analysis of Moral Injury Outcome Measures

被引：0

作者：

Brandon J. Griffin ^{[1
]}

Larry R. Price ^{[2
]}

Zakery Jenkins ^{[3
]}

Alexis Childs ^{[1
]}

Lauren Tong ^{[1
]}

Rebecca A. Raciborski ^{[2
]}

Marcela C. Weber ^{[1
]}

Jeffrey M. Pyne ^{[2
]}

Shira Maguen ^{[1
]}

Sonya B. Norman ^{[2
]}

Dawne Vogt ^{[1
]}

机构：

[1] Central Arkansas Veterans Healthcare System, Mental Health Service, 2200 Fort Roots Dr, North Little Rock, 72114, AR

[2] University of Arkansas for Medical Sciences, Little Rock, AR

[3] Texas State University, San Marcos, TX

[4] San Francisco VA Health Care System, San Francisco, CA

[5] University of CA – San Francisco, San Francisco, CA

[6] Executive Division at National Center for PTSD, VA White River Junction Healthcare System, White River Junction, VT

[7] University of CA – San Diego, San Diego, CA

[8] Women’s Health Sciences Division at National Center for PTSD, VA Boston Healthcare System, Boston, MA

[9] Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA

来源：

Current Treatment Options in Psychiatry | / 12卷 / 1期

关键词：

Depression; Meta-analysis; Moral injury; Post-traumatic stress disorder; Scale development;

D O I：

10.1007/s40501-024-00342-9

中图分类号：

学科分类号：

摘要：

Purpose of Review: As evidence accumulates for the pernicious effects of exposure to potentially morally injurious events (PMIEs) on mental health, the need for improved measurement of moral injury has grown. This article summarizes the psychometric properties of scales that assess cognitive, emotional, social, and spiritual concerns linked to PMIE exposure and uses meta-analysis to describe associations between these scales and measures of posttraumatic stress and depression. Findings: We reviewed 104 articles reporting results from 110 samples, in which 13 different scales were administered to assess the impacts of PMIE exposure (i.e., moral injury). Overall, the scales exhibited good to excellent internal consistency and moderate to large bivariate associations with posttraumatic stress (r =.63, 95% Confidence Interval [CI] [.55,.71]) and depression (r =.59, 95% CI [.51,.66]). Measures varied as to whether they indexed problems to a specific event, had a unidimensional or multidimensional factor structure, used a unipolar or bipolar response format to record item responses, used a cut score to distinguish moral injury from normative distress, were assessed for sensitivity to change over time, and were validated for use with multiple at-risk populations. Summary: Assessment of moral injury has progressed tremendously. Recent scales extend prior work that focused on whether respondents endorsed PMIE exposure by measuring the potential impacts of an exposure. Mental health clinicians and researchers can use this article to choose a scale that best fits their moral injury measurement needs. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025.

引用

共 75 条

[41] Wang Z., Koenig H.G., Tong Y., Wen J., Sui M., Liu H., Et al., Moral injury in Chinese health professionals during the COVID-19 pandemic, Psychol Trauma, 14, 2, pp. 250-257, (2022)
[42] McGuire A.P., Howard B.A.N., Erickson T.M., Creech S.K., Moral Elevation online intervention for veterans experiencing distress related to posttraumatic stress disorder and moral injury (MOVED): Pilot trial of a 4-week positive psychology web-based intervention, JMIR Form Res, 7, (2023)
[43] Dumarkaite A., Truskauskaite I., Andersson G., Jovarauskaite L., Jovaisiene I., Nomeikaite A., Et al., The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial, Int J Nurs Stud, 138, (2023)
[44] Mann A., Shah A., Thibodeau P., Dyrbye L., Syed A., Woodward M., Et al., Online well-being group coaching program for women physician trainees, Jama Network Open, 6, 10, (2023)
[45] Fainstad T., Mann A., Suresh K., Shah P., Dieujuste N., Thurmon K., Et al., Effect of a novel online group-coaching program to reduce burnout in female resident physicians: a randomized clinical trial, JAMA Netw Open, 5, 5, (2022)
[46] Currier J.M., McDermott R.C., Fernandez P., Salcone S., Hinkel H.M., Schuler K., Et al., Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization, Psychol Serv, (2023)
[47] Espinola C.W., Nguyen B., Torres A., Sim W., Rueda A., Beavers L., Et al., Digital Interventions for Stress Among Frontline Health Care Workers: Results From a Pilot Feasibility Cohort Trial, JMIR Serious Games, 12, (2024)
[48] Jones C., Smith-MacDonald L., Brown M.R.G., Pike A., Vermetten E., Bremault-Phillips S., Quantitative changes in mental health measures with 3MDR treatment for Canadian military members and veterans, Brain Behav, 12, 8, (2022)
[49] Smith-MacDonald L., Jones C., Brown M.R.G., Dunleavy R.S., VanderLaan A., Kaneva Z., Et al., Moving forward from moral injury: A mixed methods study investigating the use of 3MDR for treatment-resistant PTSD, Int J Environ Res Public Health, 20, 7, (2023)
[50] Steen S., Law G.U., Jones C., The internal consistency of the moral injury event scale: A reliability generalization meta-analysis and systematic review, Eur J Psychol Assess, (2024)

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