Abstract
Investigations about moral resilience and moral courage as mediators between moral distress and moral injury remain underreported among nurses during the COVID-19 pandemic. Nurses (n = 412) from the Philippines were conveniently recruited via social media platforms and completed four self-report scales. The mediation model depicts that moral distress negatively impacts moral resilience and moral courage while positively affecting moral injury. Moral resilience and moral courage negatively impact moral injury, whereas moral resilience directly impacts moral courage. Finally, moral resilience and moral courage demonstrated a mediating effect between moral distress and moral injury. Findings indicate that healthcare organizations and nurse managers should nurture morally resilient and courageous therapeutic practices among frontline healthcare professionals to mitigate the negative effects of moral distress and moral injury.
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Data Availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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The authors are thankful to the selfless Filipino nurses who participated in this study.
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DJEB contributed substantially to the conception and design, acquisition of data, and analysis and interpretation of data, drafting the manuscript, and revising it critically for important intellectual content. RANG contributed substantially to the study conceptualization and critically revised the manuscript for important intellectual content. DJEB and RANG gave final approval for the version to be published, participated sufficiently in the work to take public responsibility for appropriate portions of the content, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Ethics Review Committee of Universidad de Manila granted approval to conduct this study (Approval number: XXX-ERC-2021-42; approved: 11/16/2021).
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Berdida, D.J.E., Grande, R.A.N. Moral Distress, Moral Resilience, Moral Courage, and Moral Injury Among Nurses in the Philippines During the COVID-19 Pandemic: A Mediation Analysis. J Relig Health 62, 3957–3978 (2023). https://doi.org/10.1007/s10943-023-01873-w
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DOI: https://doi.org/10.1007/s10943-023-01873-w