{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:02:33Z","timestamp":1777492953896,"version":"3.51.4"},"reference-count":62,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Ethics"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moral distress contributes to serious consequences, and cultivating individual moral resilience has been proposed as a promising approach to mitigating the detrimental impact of moral distress, despite its varying definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review of the literature was conducted to analyse the concept of moral resilience in health, following the principles recommended by the Joanna Briggs Institute and the Walker and Avant conceptual analysis method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From the 39 articles included in this review, six key attributes, nine antecedents and six consequences were identified. A definition of moral resilience is described based on the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Moral resilience is the inherent ability or process to sustain, restore, or deepen one's moral integrity when confronted with moral adversity situations and moral distress. This ability can be challenged or degraded but not extinguished. Understanding the antecedents of moral resilience is crucial for developing effective strategies to promote it. Identifying the consequences of moral resilience can emphasise its importance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14777509251401123","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:44:07Z","timestamp":1765809847000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Moral resilience in health: A concept analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5188-2418","authenticated-orcid":false,"given":"Laura Sophia","family":"Da Silva","sequence":"first","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa"}]},{"given":"S\u00edlvia","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa"}]}],"member":"179","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"\u00c9tica: Ra\u00edzes e Floresc\u00eancias em Todos os Caminhos","author":"Nunes L","year":"2009","unstructured":"Nunes L. \u00c9tica: Ra\u00edzes e Floresc\u00eancias em Todos os Caminhos. Loures: Lusoci\u00eancia, 2009."},{"key":"e_1_3_3_3_2","unstructured":"Schaefer R. Sofrimento Moral: Avalia\u00e7\u00e3o de Risco em Enfermeiros [Internet] [Tese de Doutoramento]. [Porto]: Universidade Cat\u00f3lica Portuguesa: Instituto de Ci\u00eancias da Sa\u00fade; 2017. Dispon\u00edvel em: https:\/\/repositorio.ucp.pt\/bitstream\/10400.14\/24202\/1\/101652917.pdf."},{"key":"e_1_3_3_4_2","volume-title":"Moral e \u00c9tica: dimens\u00f5es intelectuais e afetivas","author":"de La Taille Y","year":"2006","unstructured":"de La Taille Y. Moral e \u00c9tica: dimens\u00f5es intelectuais e afetivas. Porto Alegre: Artmed Editora, 2006."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/journalofethics.2017.19.6.mhst1-1706"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00581"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12131364"},{"key":"e_1_3_3_8_2","first-page":"1","article-title":"Moral distress and compassion fatigue in nurses of neonatal intensive care unit","volume":"16","author":"Saleh ZN","year":"2019","unstructured":"Saleh ZN, Loghmani L, Rasouli M, et al. Moral distress and compassion fatigue in nurses of neonatal intensive care unit. Electron J Gen Med 2019; 16: 1\u20134.","journal-title":"Electron J Gen Med"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","unstructured":"Santos RPD Garros D Carnevale F. Difficult decisions in pediatric practice and moral distress in the intensive care unit. Rev Bras Ter Intensiva 2018; 30: 226\u2013232.","DOI":"10.5935\/0103-507X.20180039"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000512298.18641.31"},{"key":"e_1_3_3_11_2","article-title":"Cultivating moral resilience","volume":"117","author":"Hylton Rushton C","year":"2017","unstructured":"Hylton Rushton C. Cultivating moral resilience. AJN Am J Nurs 2017; 117: S11\u2013S15.","journal-title":"AJN Am J Nurs"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2015.02.005"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0270049"},{"key":"e_1_3_3_14_2","first-page":"703","article-title":"Values-based practice in primary care: easing the tensions between individual values, ethical principles and best evidence","volume":"56","author":"Petrova M","year":"2006","unstructured":"Petrova M, Dale J, Fulford BKWM. Values-based practice in primary care: easing the tensions between individual values, ethical principles and best evidence. Br J Gen Pract 2006; 56: 703\u2013709.","journal-title":"Br J Gen Pract"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2017.03.009"},{"key":"e_1_3_3_16_2","first-page":"144","article-title":"Conceitos e teorias na enfermagem","volume":"48","author":"Bousso RS","year":"2014","unstructured":"Bousso RS, Poles K, da Cruz D de ALM. Conceitos e teorias na enfermagem. Rev Esc Enferm USP 2014; 48: 144\u2013148.","journal-title":"Rev Esc Enferm USP"},{"key":"e_1_3_3_17_2","first-page":"9","article-title":"An\u00e1lise de conceito: conceitos, m\u00e9todos e aplica\u00e7\u00f5es em enfermagem","volume":"2","author":"Sousa LMM","year":"2018","unstructured":"Sousa LMM, Firmino CF, Carteiro DMH, et al. An\u00e1lise de conceito: conceitos, m\u00e9todos e aplica\u00e7\u00f5es em enfermagem. Rev Investig Em Enferm 2018; 2: 9\u201319.","journal-title":"Rev Investig Em Enferm"},{"key":"e_1_3_3_18_2","volume-title":"Strategies for Theory Construction in Nursing: Pearson new international edition","author":"Avant KC","year":"2014","unstructured":"Avant KC, Walker LO. Strategies for Theory Construction in Nursing: Pearson new international edition. 5.a ed. London: Pearson Education Limited, 2014.","edition":"5"},{"key":"e_1_3_3_19_2","doi-asserted-by":"crossref","unstructured":"Aromataris E Lockwood C Porritt K et al. JBI manual for evidence synthesis. JBI; 2024. https:\/\/jbi.global\/scoping-review-network\/resources.","DOI":"10.46658\/JBIMES-24-01"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.4037\/aacnacc2016275"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0000000000000868"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-023-00310-9"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2021534"},{"key":"e_1_3_3_24_2","first-page":"1","article-title":"Conceptualising moral resilience for nursing practice","volume":"26","author":"Defilippis TMLS","year":"2019","unstructured":"Defilippis TMLS, Curtis K, Gallagher A. Conceptualising moral resilience for nursing practice. Nurs Inq 2019; 26: 1\u20137.","journal-title":"Nurs Inq"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020976188"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330231177420"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330231183085"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11089-023-01097-5"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/jme-2022-108632"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2020.06.001"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13989"},{"key":"e_1_3_3_32_2","first-page":"1","article-title":"Latent profiles of nurses\u2019 moral resilience and compassion fatigue","author":"Chen X","year":"2023","unstructured":"Chen X, Zhang Y, Zheng R, et al. Latent profiles of nurses\u2019 moral resilience and compassion fatigue. Nurs Ethics 2023: 1\u201317.","journal-title":"Nurs Ethics"},{"key":"e_1_3_3_33_2","first-page":"159","article-title":"Perceived stress and its relationship to moral resilience among nurses in the hail region, Saudi Arabia","volume":"26","author":"Albaqawi H","year":"2022","unstructured":"Albaqawi H, Alrashidi MS. Perceived stress and its relationship to moral resilience among nurses in the hail region, Saudi Arabia. Makara J Health Res 2022; 26: 159\u2013164.","journal-title":"Makara J Health Res"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/17496535.2020.1771606"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-021-03637-w"},{"key":"e_1_3_3_36_2","volume-title":"Moral Resilience. Transforming Moral Suffering in Healthcare","author":"Rushton CH","year":"2018","unstructured":"Rushton CH. Moral Resilience. Transforming Moral Suffering in Healthcare. Oxford, England: Oxford University Press, 2018."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15896"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2024481"},{"key":"e_1_3_3_39_2","first-page":"1","article-title":"Effectiveness of CURA: healthcare professionals\u2019 moral resilience and moral competences","author":"Schaik M van, Pasman HRR","year":"2023","unstructured":"Schaik M van, Pasman HRR, Widdershoven GA, Snoo-Trimp JD, et al. Effectiveness of CURA: healthcare professionals\u2019 moral resilience and moral competences. Nurs Ethics 2023: 1\u201316. DOI: https:\/\/doi.org\/10.1177\/09697330231218344","journal-title":"Nurs Ethics"},{"key":"e_1_3_3_40_2","first-page":"1","article-title":"Ethical climate, moral resilience, and ethical competence of head nurses","author":"Yu Q","year":"2024","unstructured":"Yu Q, Huang C, Yan J, et al. Ethical climate, moral resilience, and ethical competence of head nurses. Nurs Ethics 2024: 1\u201315. DOI: https:\/\/doi.org\/10.1177\/09697330241230526","journal-title":"Nurs Ethics"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-023-01873-w"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0076"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-024-01911-7"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330231196229"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0328"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15873"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2023.103730"},{"key":"e_1_3_3_48_2","first-page":"203","article-title":"Moral resilience\u2014the unhappy moralist","volume":"137","author":"Oser FK","year":"2005","unstructured":"Oser FK, Reichenbach R. Moral resilience\u2014the unhappy moralist. Elsevier 2005; 137: 203\u2013224.","journal-title":"Elsevier"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-013-9469-0"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733014557140"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221085770"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/14777509211061845"},{"key":"e_1_3_3_53_2","first-page":"1","article-title":"Relationships of individual and workplace characteristics with nurses\u2019 moral resilience","author":"Brewer K","year":"2023","unstructured":"Brewer K, Ziegler H, Kurdian S, et al. Relationships of individual and workplace characteristics with nurses\u2019 moral resilience. Nurs Ethics 2023: 1\u201311. DOI: https:\/\/doi.org\/10.1177\/09697330231161692","journal-title":"Nurs Ethics"},{"key":"e_1_3_3_54_2","first-page":"1","article-title":"Moral resilience through harmonised connectedness in intensive care nursing: a grounded theory study","volume":"57","author":"Defilippis TMLS","year":"2020","unstructured":"Defilippis TMLS, Curtis K, Gallagher A. Moral resilience through harmonised connectedness in intensive care nursing: a grounded theory study. Intensive Crit Care Nurs 2020; 57: 1\u20137.","journal-title":"Intensive Crit Care Nurs"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733013505308"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14010020"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NUMA.0000834524.01865.cc"},{"key":"e_1_3_3_58_2","first-page":"1","article-title":"Towards collective moral resilience: the potential of communities of practice during the COVID-19 pandemic and beyond","author":"Delgado J","year":"2021","unstructured":"Delgado J, Siow S, de Groot J, et al. Towards collective moral resilience: the potential of communities of practice during the COVID-19 pandemic and beyond. J Med Ethics [Internet]2021; 1\u20139. [citado 1 de janeiro de 3AD]; Dispon\u00edvel em: https:\/\/pubmed.ncbi.nlm.nih.gov\/33762300\/.","journal-title":"J Med Ethics [Internet]"},{"key":"e_1_3_3_59_2","first-page":"1","article-title":"Moral distress, moral resilience, and job embeddedness among pediatric nurses","author":"Li F","year":"2023","unstructured":"Li F, Zhong J, He Z. Moral distress, moral resilience, and job embeddedness among pediatric nurses. Nurs Ethics 2023: 1\u201313.","journal-title":"Nurs Ethics"},{"key":"e_1_3_3_60_2","first-page":"86","article-title":"Translation and validation of the revised \u201crushton moral resilience scale\u201d in Greek","volume":"17","author":"Katsiroumpa A","year":"2024","unstructured":"Katsiroumpa A, Moisoglou I, Konstantakopoulou O, et al. Translation and validation of the revised \u201crushton moral resilience scale\u201d in Greek. Int J Caring Sci 2024; 17: 86\u201394.","journal-title":"Int J Caring Sci"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.4037\/aacnacc2024727"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/6808266"},{"key":"e_1_3_3_63_2","doi-asserted-by":"crossref","unstructured":"Bergman A Nelson K Boyce D et al. Moral resilience and moral injury of nurse leaders during crisis situations: a qualitativedescriptive analysis. Nurs Manage 2024; 55: 16\u201326.","DOI":"10.1097\/nmg.0000000000000196"}],"container-title":["Clinical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14777509251401123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14777509251401123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14777509251401123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:53:57Z","timestamp":1777388037000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14777509251401123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":62,"alternative-id":["10.1177\/14777509251401123"],"URL":"https:\/\/doi.org\/10.1177\/14777509251401123","relation":{},"ISSN":["1477-7509","1758-101X"],"issn-type":[{"value":"1477-7509","type":"print"},{"value":"1758-101X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]},"article-number":"14777509251401123"}}