Date of Award
Graduate School of Social Work
Jennifer C. Greenfield
Health, Healthcare, Moral injury, Social work, Well-being, Workforce
The well-being of the healthcare workforce in the United States is important. Specifically, healthcare social workers (HSWs) are critical to the workflow of healthcare services. HSWs have a unique role in healthcare, addressing the psychosocial needs of patients. Despite their essential roles, HSWs receive minimal attention regarding their workplace-related well-being. This dissertation examined the experience of moral injury, an indicator of well-being, amongst HSW. Moral injury is “the moral transgression, or boundary breaking, by oneself or someone in a position of power, in high stakes situations, and the negative outcomes of those experiences” (Litz & Kerig, 2019; Shay, 2014).
This dissertation was a three-aim mixed methods scale development study. Aim one summarized relevant literature on moral injury and well-being in a registered systematic review. Aim two examined experiences of moral injury amongst HSWs in a Mountain West state using semi-structured interviews and hybrid qualitative analysis, using both thematic and rapid analyses. Aim three piloted the Moral Injury Symptom Scale- Healthcare Social Workers (MISS-HSW) in a national U.S. healthcare social worker well-being survey. Psychometric properties were examined on the MISS-HSW, including exploratory factor analysis.
The systematic review included 18 articles, illuminating the relationship between moral injury and well-being (e.g., burnout, trauma, mental health indicators). The interviews included 24 participants, and the thematic analysis developed three themes: 1) HSWs’ experiences of moral injury; 2) HSWs situated in the “in-between” of policy and practice; and 3) upholding social work values within the medical model. The rapid analysis created the MISS-HSW. The survey included 158 participants from 22 states in the United States. The MISS-HSW had strong reliability (a = 0.86) and produced two factors: 1) emotions and 2) values/purpose.
This dissertation contributes to the healthcare workforce well-being literature through the analysis of moral injury amongst HSWs. The new MISS-HSW is publicly available for HSW departments to use for self or staff screening of moral injury. This study provides data to support policy-level changes that can be implemented to better support HSWs. This dissertation provides foundational evidence and methodologies to support future study of moral injury and HSW well-being.
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Pari Shah Thibodeau
Received from ProQuest
Thibodeau, Pari Shah, "Measuring Moral Injury Amongst Healthcare Social Workers: A Mixed Methods Scale Development Study" (2023). Electronic Theses and Dissertations. 2232.
Available for download on Thursday, August 01, 2024