Mindy J. Vanderloo, Ethan Evans, Andrew Smith, Megan Call, Amy Locke, Hannah Wright, Karen W. Tao
{"title":"护士道德伤害相关经历的探索：护士访谈的反身性主题分析","authors":"Mindy J. Vanderloo, Ethan Evans, Andrew Smith, Megan Call, Amy Locke, Hannah Wright, Karen W. Tao","doi":"10.1111/jan.16856","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>To provide a description of nurses' experiences related to moral injury, including Potentially Morally Injurious Events and factors related to the impact of those events.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Reflexive thematic analysis of nurse interviews.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>Nurses 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Interviews 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Potentially 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.</p>\n </section>\n \n <section>\n \n <h3> Impact</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Patient or Public Contribution</h3>\n \n <p>No Patient or Public Contribution.</p>\n </section>\n </div>","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"81 10","pages":"6843-6854"},"PeriodicalIF":3.4000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jan.16856","citationCount":"0","resultStr":"{\"title\":\"Exploration of Nurses' Experiences Related to Moral Injury: A Reflexive Thematic Analysis of Nurse Interviews\",\"authors\":\"Mindy J. Vanderloo, Ethan Evans, Andrew Smith, Megan Call, Amy Locke, Hannah Wright, Karen W. Tao\",\"doi\":\"10.1111/jan.16856\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>To provide a description of nurses' experiences related to moral injury, including Potentially Morally Injurious Events and factors related to the impact of those events.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Reflexive thematic analysis of nurse interviews.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>Nurses 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Interviews 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Potentially 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Impact</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patient or Public Contribution</h3>\\n \\n <p>No Patient or Public Contribution.</p>\\n </section>\\n </div>\",\"PeriodicalId\":54897,\"journal\":{\"name\":\"Journal of Advanced Nursing\",\"volume\":\"81 10\",\"pages\":\"6843-6854\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jan.16856\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Advanced Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jan.16856\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Advanced Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jan.16856","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Exploration of Nurses' Experiences Related to Moral Injury: A Reflexive Thematic Analysis of Nurse Interviews
Aim
To provide a description of nurses' experiences related to moral injury, including Potentially Morally Injurious Events and factors related to the impact of those events.
Design
Reflexive thematic analysis of nurse interviews.
Method
Nurses 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.
Results
Interviews 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.
Conclusion
Potentially 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.
期刊介绍：
The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy.
All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.
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