Abstract
The COVID-19 pandemic has been associated with various health-related issues among nurses, including mental health problems such as moral injury. This study aimed to evaluate the relationship between moral injury, general health, post-traumatic stress disorder (PTSD), and type of hospital among Iranian nurses working in different clinical settings during the COVID-19 outbreak. This cross-sectional study employed convenience sampling to recruit 334 nurses working in various clinical settings, including teaching and referral hospitals, in Kerman, Southeastern Iran from October 2021 to February 2022. The study used three measures, including the General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and The Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). Data analysis was conducted using SPSS25. The results indicated that moral injury was highly prevalent among Iranian nurses, with 47% of the participants reporting experiencing it. A total, 26.9% of the participants reported experiencing mental health disorders and 57.2% of the participants reported experiencing this disorder. Significant correlations were found between moral injury, general health, and PTSD. Specifically, moral injury levels were higher among female nurses with a history of mental disorders and those designated to treat all kinds of cases, compared to other participants. The results suggest that Iranian nurses are at a high risk of experiencing moral injury during the COVID-19 pandemic. Policymakers and health authorities should establish related health educational programs, provide counseling services to promote general health, and pay particular attention to moral injury and PTSD. Additionally, nurse educators should integrate materials related to moral injury into the nursing curriculum.
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We would like to thank all participants for their cooperation. The approved research project code was 99000547.
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Mahlagha Dehghan and Alireza Malakoutikhah contributed to the research design. Mahlagha Dehghan conducted the analysis. Alireza Malakoutikhah and Sima Mokhtarabadi checked and prepared the measures and supervised data collection. Hemn Kaka Mirza, Rasmieh Al-Amer and Samaneh Behzadi Fard prepared the first draft of the manuscript, and all authors read, commented, and approved the final version.
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Liang, T., Kaka Mirza, H., Malakoutikhah, A. et al. Moral Injury and its Correlates among Iranian Nurses in the Second Year of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study. J Relig Health 62, 3979–3994 (2023). https://doi.org/10.1007/s10943-023-01938-w
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DOI: https://doi.org/10.1007/s10943-023-01938-w