ABSTRACT

In recognition that existing theoretical paradigms may not offer a comprehensive account of the range of occupational stressors and responses experienced by healthcare professionals, interest in moral injury has grown. The Moral Injury Events Scale (MIES) remains the dominant assessment tool used to measure potentially morally injurious experiences (PMIEs) across different occupational groups, including healthcare professionals. Given the proliferation of research using the MIES in healthcare, in the context of ongoing debates about its structure and utility, an exploration of the psychometric properties of the MIES with this population is timely. Using the data (N = 235) from a study exploring the prevalence of exposure to PMIEs, the current study reports on the factor structure of the MIES in healthcare professionals working within a secure mental health setting. The results yielded a two-factor model representing transgressions and betrayals by ‘others’, and transgressions committed by the ‘self’. Exploration of the internal consistency of the scale yielded a McDonald’s ω of .93. Multi-group confirmatory factor analysis highlighted the model was an adequate fit for White females, tentatively suggesting that experiences of moral injury may vary by gender, intersected by ethnicity. Accordingly, future frameworks, measures and interventions to remediate the impact of moral injury may require an intersectional approach.

摘要

认识到现有的理论范式可能无法全面说明医疗保健专业人员所经历的职业压力源和反应的范围，对道德伤害的兴趣与日俱增。道德伤害事件量表 (MIES) 仍然是用于衡量包括医疗保健专业人员在内的不同职业群体的潜在道德伤害经历 (PMIE) 的主要评估工具。鉴于在医疗保健中使用 MIES 的研究激增，在关于其结构和效用的持续辩论的背景下，对 MIES 与该人群的心理测量特性进行探索是及时的。使用来自一项探索暴露于 PMIE 患病率的研究的数据 (N = 235)，目前的研究报告了在安全的心理健康环境中工作的医疗保健专业人员的 MIES 因素结构。结果产生了一个双因素模型，代表“他人”的越轨和背叛，以及“自己”的越轨。探索量表的内部一致性得出麦当劳的 ω 为 0.93。多组验证性因素分析强调该模型非常适合白人女性，初步表明道德伤害的经历可能因性别而异，因种族而异。因此，未来补救精神伤害影响的框架、措施和干预措施可能需要采用交叉方法。探索量表的内部一致性得出麦当劳的 ω 为 0.93。多组验证性因素分析强调该模型非常适合白人女性，初步表明道德伤害的经历可能因性别而异，因种族而异。因此，未来补救精神伤害影响的框架、措施和干预措施可能需要采用交叉方法。探索量表的内部一致性得出麦当劳的 ω 为 0.93。多组验证性因素分析强调该模型非常适合白人女性，初步表明道德伤害的经历可能因性别而异，因种族而异。因此，未来补救精神伤害影响的框架、措施和干预措施可能需要采用交叉方法。