Defining and Assessing the Syndrome of Moral Injury: Initial Findings of the Moral Injury Outcome Scale Consortium.
Defining and Assessing the Syndrome of Moral Injury: Initial Findings of the Moral Injury Outcome Scale Consortium.
复制标题
DOI：
10.3389/fpsyt.2022.923928
复制
发表时间：
2022
影响因子：
4.7
通讯作者：
Moral Injury Outcome Scale Consortium
中科院分区：
文献类型：
--
作者：
Litz, Brett T.;Plouffe, Rachel A.;Nazarov, Anthony;Murphy, Dominic;Phelps, Andrea;Coady, Alanna;Houle, Stephanie A.;Dell, Lisa;Frankfurt, Sheila;Zerach, Gadi;Levi-Belz, Yossi;Moral Injury Outcome Scale Consortium
关键词：
潜在的道德伤害性事件（PMIE）涉及委员会的行为（例如，残忍、被禁止或规定的暴力）或不作为（例如，高风险未能保护他人）和作证（例如，严重的不人道行为，可怕的暴力后果），或成为他人犯罪行为的受害者（例如，高风险信任违反）或遗漏（例如，成为严重的个人或系统性保护失败的受害者），违背了对对错的根深蒂固的信念和期望。尽管人们对精神伤害（与暴露于PMIE相关的结果）的兴趣激增，但对推定的综合征没有可操作的定义，也没有标准的评估方案或措施，这阻碍了这一领域的研究和护理。我们描述了一个国际性的努力，以定义精神伤害的综合征，并开发和验证的精神伤害结果量表（米奥斯）分三个阶段。为了确保内容的有效性，在第一阶段，我们对每个国家的服务人员，退伍军人和临床医生/牧师进行了采访，询问PMIE的持久影响。定性分析产生了六个业务定义的PMIEs和组件的影响领域内的域，建立参数的精神伤害综合征。从域定义中，我们得到了一个初始池的规模项目。第二阶段需要使用因素分析方法，跨国不变性测试，和内部一致性可靠性分析的初始34项米奥斯规模细化。一个14项的米奥斯是不变的，可靠的国家之间，有两个因素：羞耻相关（SR）和信任违背相关（TVR）的结果。在第三阶段，米奥斯总分和分量表得分有很强的收敛效度，PMIE赞同者的米奥斯得分显著高于非赞同者。我们讨论和上下文的结果和描述的研究，需要证实这些就职的调查结果，以进一步探讨的有效性的米奥斯和精神伤害，特别是检查歧视和增量效度。
Potentially morally injurious events (PMIEs) entail acts of commission (e.g., cruelty, proscribed or prescribed violence) or omission (e.g., high stakes failure to protect others) and bearing witness (e.g., to grave inhumanity, to the gruesome aftermath of violence), or being the victim of others' acts of commission (e.g., high stakes trust violations) or omission (e.g., being the victim of grave individual or systemic failures to protect) that transgress deeply held beliefs and expectations about right and wrong. Although there is a proliferation of interest in moral injury (the outcome associated with exposure to PMIEs), there has been no operational definition of the putative syndrome and no standard assessment scheme or measure, which has hampered research and care in this area. We describe an international effort to define the syndrome of moral injury and develop and validate the Moral Injury Outcome Scale (MIOS) in three stages. To ensure content validity, in Stage I, we conducted interviews with service members, Veterans, and clinicians/Chaplains in each country, inquiring about the lasting impact of PMIEs. Qualitative analysis yielded six operational definitions of domains of impact of PMIEs and components within domains that establish the parameters of the moral injury syndrome. From the domain definitions, we derived an initial pool of scale items. Stage II entailed scale refinement using factor analytic methods, cross-national invariance testing, and internal consistency reliability analyses of an initial 34-item MIOS. A 14-item MIOS was invariant and reliable across countries and had two factors: Shame-Related (SR) and Trust-Violation-Related (TVR) Outcomes. In Stage III, MIOS total and subscale scores had strong convergent validity, and PMIE-endorsers had substantially higher MIOS scores vs. non-endorsers. We discuss and contextualize the results and describe research that is needed to substantiate these inaugural findings to further explore the validity of the MIOS and moral injury, in particular to examine discriminant and incremental validity.
登录
查看更多内容
DOI：
10.1080/10705510701301834
发表时间：
2005-01-01
影响因子：
6
作者：
Chen, FF;Sousa, KH;West, SG
通讯作者：
West, SG
影响因子：
3.6
作者：
Clark, LA;Watson, D
通讯作者：
Watson, D
DOI：
10.1080/13645579.2019.1630899
发表时间：
2019-06-16
影响因子：
3.3
作者：
Faran, Yifat;Zanbar, Lea
通讯作者：
Zanbar, Lea
DOI：
10.1037/tra0000249
发表时间：
2017-11-01
影响因子：
6.3
作者：
Jordan, Alexander H.;Eisen, Ethan;Litz, Brett T.
通讯作者：
Litz, Brett T.
影响因子：
3.6
作者：
Currier, Joseph M.;Farnsworth, Jacob K.;Albright, David L.
通讯作者：
Albright, David L.