Abstract：
Moral injury has emerged as an important construct for understanding the distress experienced in the aftermath of a moral violation, initially among combat veterans and increasingly among other populations, such as healthcare workers and first responders. While numerous measures have been validated to assess for exposure to potentially morally injurious events and/or sequelae, additional tools are needed to facilitate nuanced discussion of the experience of moral injury in therapeutic encounters. The Moral Injury Experience Wheel (MIEW; Fleming, 2023) is an infographic instrument that is designed to elicit precise language and help differentiate feelings in an effort to process morally perplexing circumstances. This paper describes the contents and potential clinical applications of a newly developed manual to guide the use of the MIEW. The MIEW and manual are designed to be used independently or alongside existing moral injury interventions. A case study featuring the use of the MIEW and manual demonstrates how the tools can be used in a professional healthcare setting. Recommendations for moral injury care practitioners are provided.
摘要：
道德伤害已成为理解道德违反后所经历的痛苦的重要建构，最初是在战斗退伍军人中，越来越多的是在其他人群中，例如医护人员和急救人员。虽然已经验证了许多措施来评估是否暴露于潜在的道德伤害事件和/或后遗症，需要额外的工具来促进对治疗性遭遇中道德伤害经验的细微差别讨论。道德伤害体验之轮(MIEW；弗莱明，2023）是一种信息图表工具，旨在引出精确的语言并帮助区分情感，以处理道德上令人困惑的情况。本文介绍了新开发的手册的内容和潜在的临床应用，以指导MIEW的使用。MIEW和手册旨在独立使用或与现有的道德伤害干预措施一起使用。使用MIEW和手册的案例研究演示了如何在专业医疗保健环境中使用这些工具。提供了对精神伤害护理从业人员的建议。
