A Review of the Scope of Factors Influencing Ethical Injury Among Clinical Nurses

Abstract

Objective: To conduct a scoping review of factors associated with ethical trauma among clinical nurses, providing a reference for alleviating such trauma. Methods: Guided by the methodology of a scoping review, a systematic search was conducted in PubMed, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and the China Biomedical Literature Database. The search period spanned from the inception of each database to June 20, 2026. Two researchers independently screened, synthesized, and extracted data from the search results. Results: A total of 12 studies were included. Factors influencing MI among clinical nurses include four aspects: individual physical and psychological characteristics, experiences of occupational stress, the organizational ethical environment, and external social support. Conclusion: MI is a negative psychological stress experience frequently encountered by clinical nurses, which severely affects their physical and mental health and is influenced by multiple factors. At present, research on moral injury (MI) among clinical nurses in China is still in its early stages. There is an urgent need to develop assessment tools tailored to China’s national conditions and to conduct multicenter, large-sample, and longitudinal studies to explore the current status and influencing factors of MI among clinical nurses in China, thereby providing a theoretical basis for the development of intervention measures.