The Moral Impact of the COVID-19 Pandemic on Nurses’ Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic Psychological Needs
Abstract
:1. Introduction
1.1. Potentially Morally Injurious Events in Healthcare during the COVID-19 Pandemic
1.2. Autobiographical Episodic Memories of Moral Transgressions
1.3. Autonomy Thwarting in Work-Related, Autobiographical Episodic Memories
1.4. Work Motivation
1.5. Moral Learning following Moral Memory Recall
1.6. Burnout
1.7. Work Satisfaction
1.8. Adaptive Performance
1.9. Current Study
- Path 1: Burnout as the Main Mechanism
- 2.
- Path 2: Work Satisfaction as the Main Mechanism
- 3.
- Path 3: Moral Learning as the Main Mechanism
2. Materials and Methods
2.1. Sample
2.1.1. Participants Recruiting
2.1.2. Final Sample Description
2.1.3. Ethics
2.2. Procedure and Instruments
2.3. Data Analyses Strategy
3. Results
3.1. Socio-Demographic Differences
3.2. Self-Defining Memories of PMIEs and SMTs
3.3. Path Analysis of the Conceptual Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Experimental Procedure
Appendix B
Predictors | Outcome Variables | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Adaptive Performance | Burnout | Work Satisfaction | Moral Learning | Work Motivation | Autonomy Thwarting | |||||||
VIF | T | VIF | T | VIF | T | VIF | T | VIF | T | VIF | T | |
Autonomy Thwarting | 1.68 | 0.59 | 1.37 | 0.73 | 1.37 | 0.73 | 1.37 | 0.73 | 1.13 | 0.88 | ||
Moral Learning | 1.71 | 0.59 | ||||||||||
Work Motivation | 1.94 | 0.52 | 1.62 | 0.62 | 1.62 | 0.62 | 1.62 | 0.62 | 1.13 | 0.89 | ||
Work Satisfaction | 1.6 | 0.63 | ||||||||||
Burnout | 1.67 | 0.6 | ||||||||||
Experimental Condition a | 1.46 | 0.68 | 1.34 | 0.75 | 1.34 | 0.75 | 1.34 | 0.75 | 1.01 | 0.99 | ||
Age | 1.03 | 0.97 | 1.01 | 0.99 | 1.01 | 0.99 | 1.01 | 0.99 | ||||
Gender | 1.02 | 0.98 | 1.01 | 0.99 | 1 | 0.99 |
Appendix C. Outliers Treatment
Paths a | Label | B d | SE | 95% CI b | z | p | Β e | H | |
---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||
Autonomy ← PMIE vs. SMT recall c | a | 1.65 | 0.2 | 1.27 | 2.03 | 8.44 | <0.001 | 0.34 | H2 |
Autonomy ←Age | 0.02 | 0.01 | −0.00 | 0.05 | 1.77 | 0.077 | 0.08 | ||
Work Motivation ← Autonomy | b | −1.37 | 0.13 | −1.63 | −1.11 | −10.39 | <0.001 | −0.36 | H3 |
Work Motivation ← PMIE vs. SMT recall | −7.32 | 0.67 | −8.62 | −5.98 | −10.86 | <0.001 | −0.39 | ||
Work Motivation ← Age | −0.02 | 0.04 | −0.09 | 0.05 | −0.57 | 0.571 | −0.02 | ||
Work Motivation ← Gender | 2.09 | 0.94 | 0.28 | 3.93 | 2.22 | 0.026 | 0.08 | ||
Moral Learning ← Work Motivation | c | 0.05 | 0.01 | 0.03 | 0.07 | 5.51 | <0.001 | 0.33 | H4 |
Moral Learning ← Autonomy | −0.21 | 0.03 | −0.26 | −0.15 | −7.3 | <0.001 | −0.36 | ||
Moral Learning ← PMIE vs. SMT recall | −0.36 | 0.14 | −0.62 | −0.08 | −2.53 | 0.012 | −0.12 | ||
Moral Learning ← Gender | 0.26 | 0.13 | 0 | 0.51 | 1.94 | 0.052 | 0.06 | ||
Work Satisfaction ← Work Motivation | e | 0.25 | 0.03 | 0.19 | 0.31 | 8.25 | <0.001 | 0.42 | |
Work Satisfaction ← Autonomy | −0.57 | 0.09 | −0.75 | −0.38 | −6.05 | <0.001 | −0.25 | ||
Work Satisfaction ← PMIE vs. SMT recall | j | −1.34 | 0.45 | −2.2 | −0.44 | −2.97 | 0.003 | −0.12 | |
Work Satisfaction ← Age | −0.05 | 0.02 | −0.09 | −0.01 | −2.38 | 0.017 | −0.07 | ||
Burnout ← Work Motivation | d | −0.34 | 0.05 | −0.44 | −0.24 | −6.5 | <0.001 | −0.36 | |
Burnout ← Autonomy | 1.06 | 0.18 | 0.71 | 1.4 | 6.06 | <0.001 | 0.3 | ||
Burnout ← PMIE vs. SMT recall | k | 2.66 | 0.81 | 1.03 | 4.2 | 3.3 | 0.001 | 0.15 | |
Adaptive Performance ← Burnout | f | −0.32 | 0.07 | −0.46 | −0.19 | −4.61 | <0.001 | −0.14 | |
Adaptive Performance ← Moral Learning | g | 3 | 0.41 | 2.21 | 3.81 | 7.42 | <0.001 | 0.22 | |
Adaptive Performance ← Work Satisfaction | h | 0.63 | 0.11 | 0.41 | 0.85 | 5.5 | <0.001 | 0.18 | |
Adaptive Performance ← Work Motivation | 0.62 | 0.08 | 0.47 | 0.79 | 7.71 | <0.001 | 0.3 | ||
Adaptive Performance ← Autonomy | −1.02 | 0.24 | −1.47 | −0.55 | −4.32 | <0.001 | −0.13 | ||
Adaptive Performance ← PMIE vs. SMT recall | i | −4.27 | 1.01 | −6.2 | −2.23 | −4.22 | <0.001 | −0.11 | |
Adaptive Performance ← Age | −0.03 | 0.05 | −0.13 | 0.08 | −0.53 | 0.593 | −0.01 | ||
Adaptive Performance ← Gender | −1.12 | 1.13 | −3.4 | 1.07 | −1 | 0.320 | −0.02 |
Effects | Label | B b | SE | 95% CI c | z | p | Β d | H | |
---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||
Indirect Effect PMIE vs. SMT recall a to Adaptive Performance through Burnout | a*b*d*f | −0.24 | 0.07 | −0.41 | −0.12 | −3.31 | 0.001 | −0.01 | H5 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Burnout | i | −4.27 | 1.01 | −6.2 | −2.23 | −4.22 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Burnout | i + a*b*d*f | −4.52 | 1.01 | −6.44 | −2.47 | −4.51 | <0.001 | −0.12 | |
Indirect Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | a*b*c*g | −0.35 | 0.09 | −0.55 | −0.2 | −3.81 | <0.001 | −0.01 | H7 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | i | −4.27 | 1.01 | −6.2 | −2.23 | −4.22 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | i + a*b*c*g | −4.62 | 1.02 | −6.57 | −2.57 | −4.55 | <0.001 | −0.12 | |
Indirect Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | a*b*e*h | −0.35 | 0.1 | −0.56 | −0.19 | −3.67 | <0.001 | −0.01 | H6 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | i | −4.27 | 1.01 | −6.2 | −2.23 | −4.22 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | i + a*b*e*h | −4.62 | 1.02 | −6.57 | −2.56 | −4.54 | <0.001 | −0.12 | |
Indirect Effect PMIE vs. SMT recall to Burnout | a*b*d | 0.76 | 0.17 | 0.46 | 1.14 | 4.43 | <0.001 | 0.04 | H5 |
Direct Effect PMIE vs. SMT recall to Burnout | k | 2.66 | 0.81 | 1.03 | 4.2 | 3.3 | 0.001 | 0.15 | |
Total Effect PMIE vs. SMT recall to Burnout | k + a*b*d | 3.62 | 0.76 | 1.89 | 4.88 | 4.52 | <0.001 | 0.2 | |
Indirect Effect PMIE vs. SMT recall to Work Satisfaction | a*b*e | −0.56 | 0.11 | −0.80 | −0.37 | −5.1 | <0.001 | −0.05 | H6 |
Direct Effect PMIE vs. SMT recall to Work Satisfaction | j | −1.34 | 0.45 | −2.2 | −0.44 | −2.98 | 0.003 | −0.12 | |
Total Effect PMIE vs. SMT recall to Work Satisfaction | j + a*b*e | −1.9 | 0.43 | −2.74 | −1.05 | −4.43 | <0.001 | −0.17 |
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1 | 2 | 3 | 4 | 5 | 6 | 7 | |||
---|---|---|---|---|---|---|---|---|---|
1. | Autonomy thwarting | Pearson’s r | — | ||||||
p-value | — | ||||||||
95% CI UL | — | ||||||||
95% CI LL | — | ||||||||
2. | Moral learning | Pearson’s r | −0.53 *** | — | |||||
p-value | < 0.001 | — | |||||||
95% CI UL | −0.47 | — | |||||||
95% CI LL | −0.58 | — | |||||||
3. | Work motivation | Pearson’s r | −0.51 *** | 0.52 *** | — | ||||
p-value | < 0.001 | <0.001 | — | ||||||
95% CI UL | −0.45 | 0.58 | — | ||||||
95% CI LL | −0.57 | 0.46 | — | ||||||
4. | Work satisfaction | Pearson’s r | −0.46 *** | 0.46 *** | 0.52 *** | — | |||
p-value | < 0.001 | <0.001 | <0.001 | — | |||||
95% CI UL | −0.4 | 0.52 | 0.58 | — | |||||
95% CI LL | −0.52 | 0.4 | 0.46 | — | |||||
5. | Burnout | Pearson’s r | 0.49 *** | −0.48 *** | −0.53 *** | −0.42 *** | — | ||
p-value | < 0.001 | <0.001 | <0.001 | <0.001 | — | ||||
95% CI UL | 0.55 | −0.42 | −0.48 | −0.35 | — | ||||
95% CI LL | 0.43 | −0.54 | −0.59 | −0.48 | — | ||||
6. | Adaptive performance | Pearson’s r | −0.59 *** | 0.64 *** | 0.69 *** | 0.6 *** | −0.59 *** | — | |
p-value | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | — | |||
95% CI UL | −0.54 | 0.68 | 0.73 | 0.65 | −0.53 | — | |||
95% CI LL | −0.64 | 0.59 | 0.65 | 0.55 | −0.64 | — | |||
7. | Work experience | Pearson’s r | 0.06 | −0.02 | −0.03 | −0.11 ** | 0.01 | −0.06 | — |
p-value | 0.149 | 0.679 | 0.48 | 0.006 | 0.732 | 0.155 | — | ||
95% CI UL | 0.14 | 0.06 | 0.05 | −0.03 | 0.09 | 0.02 | — | ||
95% CI LL | −0.02 | −0.1 | −0.11 | −0.19 | −0.07 | −0.14 | — | ||
8. | Age | Pearson’s r | 0.1 * | −0.05 | −0.08 * | −0.15 *** | 0.02 | −0.1 * | 0.83 *** |
p-value | 0.013 | 0.245 | 0.04 | <0.001 | 0.56 | 0.012 | <0.001 | ||
95% CI UL | 0.18 | 0.03 | 0 | −0.07 | 0.1 | −0.02 | 0.85 | ||
95% CI LL | 0.02 | −0.13 | −0.16 | −0.22 | −0.06 | −0.18 | 0.8 |
Variable | Group | Mean | SD | Welch’s t | df | p | Mean Difference | SE Difference | 95% CI | Cohen’s d | |
---|---|---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||||
Autonomy thwarting | M | 2.73 | 2.6 | 1.36 | 118 | 0.176 | 0.4 | 0.3 | −0.18 | 0.99 | 0.16 |
F | 2.33 | 2.46 | |||||||||
Moral learning | M | 2.71 | 1.37 | −3.4 | 126 | <0.001 | −0.54 | 0.16 | −0.85 | −0.22 | −0.38 |
F | 3.25 | 1.45 | |||||||||
Work motivation | M | −5.73 | 8.53 | −2.49 | 132 | 0.014 | −2.48 | 0.99 | −4.44 | −0.51 | −0.27 |
F | −3.25 | 9.7 | |||||||||
Work satisfaction | M | 17.78 | 5.28 | −1.96 | 126 | 0.052 | −1.19 | 0.61 | −2.4 | 0.01 | −0.22 |
F | 18.97 | 5.63 | |||||||||
Burnout | M | 35.91 | 8.04 | 1.96 | 129 | 0.053 | 1.82 | 0.93 | −0.02 | 3.67 | 0.22 |
F | 34.09 | 8.86 | |||||||||
Adaptive performance | M | 67.67 | 17.78 | −2.2 | 133 | 0.029 | −4.58 | 2.08 | −8.69 | −0.47 | −0.24 |
F | 72.25 | 20.57 |
Variable | Group c | Mean | SD | Welch’s F | df1 | df2 | p | Games-Howell Post-Hoc Tests | p | ||
---|---|---|---|---|---|---|---|---|---|---|---|
Mean Difference | t | df | |||||||||
Autonomy thwarting | Post-Secondary | 2.39 | 2.5 | 0.08 | 2 | 37.5 | 0.922 | ||||
Bachelor’s | 2.32 | 2.33 | |||||||||
Masters’ | 2.57 | 2.25 | |||||||||
Moral learning | Post-Secondary | 3.15 | 1.43 | 0.63 | 2 | 36.3 | 0.54 | ||||
Bachelor’s | 3.45 | 1.59 | |||||||||
Masters’ | 3.3 | 1.61 | |||||||||
Work motivation | Post-Secondary | −3.8 a | 9.69 | 3.88 | 2 | 38.5 | 0.029 | M a − M b = −3.79 | −2.79 | 36 | 0.022 |
Bachelor’s | −0.01 b | 7.2 | |||||||||
Masters’ | −3.98 | 8.73 | |||||||||
Work satisfaction | Post-Secondary | 18.78 | 5.62 | 0.77 | 2 | 37.4 | 0.472 | ||||
Bachelor’s | 19.68 | 5.59 | |||||||||
Masters’ | 17.87 | 5.01 | |||||||||
Burnout | Post-Secondary | 34.38 | 8.85 | 0.09 | 2 | 37.9 | 0.914 | ||||
Bachelor’s | 34.29 | 8.67 | |||||||||
Masters’ | 33.74 | 6.99 | |||||||||
Adaptive performance | Post-Secondary | 71.53 | 20.33 | 0.66 | 2 | 37.2 | 0.524 | ||||
Bachelor’s | 74.65 | 18.02 | |||||||||
Masters’ | 68.65 | 21.12 |
M | SD | Skew | Kurtosis | VIF | Tolerance | 1 | 2 | 3 | 4 | 5 | 6 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Adaptive performance | 71.6 | 20.2 | 0.09 | −0.36 | — | — | — | |||||
2. Autonomy thwarting | 2.39 | 2.48 | −0.11 | −0.86 | 1.68 | 0.60 | −0.59 *** | — | ||||
3. Moral learning | 3.17 | 1.45 | 0.25 | −0.64 | 1.69 | 0.59 | 0.64 *** | −0.52 *** | — | |||
4. Work motivation | −3.61 | 9.57 | −0.11 | −0.63 | 1.94 | 0.52 | 0.69 *** | −0.51 *** | 0.52 *** | — | ||
5. Work satisfaction | 18.8 | 5.59 | −0.15 | −0.62 | 1.58 | 0.63 | 0.60 *** | −0.46 *** | 0.46 *** | 0.52 *** | — | |
6. Burnout | 34.4 | 8.77 | 0.21 | −0.67 | 1.66 | 0.60 | −0.59 *** | 0.49 *** | −0.48 *** | −0.53 *** | −0.42 *** | — |
7. Experimental condition a | — | — | — | — | 1.46 | 0.69 | −0.52 *** | 0.33 *** | −0.40 *** | −0.50 *** | −0.41 *** | 0.44 *** |
Paths a | Label | B d | SE | 95% CI b | z | p | Β e | H | |
---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||
Autonomy ← PMIE vs. SMT recall c | a | 1.58 | 0.2 | 1.19 | 1.96 | 8.08 | <0.001 | 0.32 | H2 |
Autonomy ← Age | 0.02 | 0.01 | 0 | 0.04 | 1.6 | 0.109 | 0.07 | ||
Work Motivation ← Autonomy | b | −1.44 | 0.14 | −1.71 | −1.18 | −10.68 | <0.001 | −0.38 | H3 |
Work Motivation ← PMIE vs. SMT recall | −6.88 | 0.69 | −8.23 | −5.51 | −10.02 | <0.001 | −0.36 | ||
Work Motivation ← Age | −0.01 | 0.04 | −0.08 | 0.06 | −0.33 | 0.744 | −0.01 | ||
Work Motivation ← Gender | 1.87 | 0.92 | 0.04 | 3.71 | 2.03 | 0.043 | 0.07 | ||
Moral Learning ← Work Motivation | c | 0.05 | 0.01 | 0.03 | 0.07 | 5.36 | <0.001 | 0.31 | H4 |
Moral Learning ← Autonomy | −0.21 | 0.03 | −0.26 | −0.15 | −7.42 | <0.001 | −0.36 | ||
Moral Learning ← PMIE vs. SMT recall | −0.41 | 0.14 | −0.68 | −0.13 | −2.98 | 0.003 | −0.14 | ||
Moral Learning ← Gender | 0.33 | 0.13 | 0.06 | 0.58 | 2.49 | 0.013 | 0.08 | ||
Work Satisfaction ← Work Motivation | e | 0.2 | 0.03 | 0.14 | 0.27 | 6.53 | <0.001 | 0.35 | |
Work Satisfaction ← Autonomy | −0.57 | 0.1 | −0.77 | −0.38 | −5.79 | <0.001 | −0.25 | ||
Work Satisfaction ← PMIE vs. SMT recall | j | −1.83 | 0.48 | −2.77 | −0.89 | −3.8 | <0.001 | −0.16 | |
Work Satisfaction ← Age | −0.06 | 0.02 | −0.1 | −0.02 | −2.9 | 0.004 | −0.09 | ||
Burnout ← Work Motivation | d | −0.3 | 0.05 | −0.4 | −0.21 | −6.17 | <0.001 | −0.33 | |
Burnout ← Autonomy | 1.03 | 0.17 | 0.69 | 1.36 | 6.08 | <0.001 | 0.29 | ||
Burnout ← PMIE vs. SMT recall | k | 3.35 | 0.77 | 1.79 | 4.81 | 4.33 | <0.001 | 0.19 | |
Adaptive Performance ← Burnout | f | −0.33 | 0.08 | −0.49 | −0.18 | −4.2 | <0.001 | −0.14 | |
Adaptive Performance ← Moral Learning | g | 3.19 | 0.52 | 2.2 | 4.23 | 6.13 | <0.001 | 0.23 | |
Adaptive Performance ← Work Satisfaction | h | 0.7 | 0.15 | 0.41 | 0.99 | 4.69 | <0.001 | 0.19 | |
Adaptive Performance ← Work Motivation | 0.56 | 0.1 | 0.36 | 0.77 | 5.42 | <0.001 | 0.26 | ||
Adaptive Performance ← Autonomy | −1.14 | 0.31 | −1.73 | −0.52 | −3.68 | <0.001 | −0.14 | ||
Adaptive Performance ← PMIE vs. SMT recall | i | −4.3 | 1.12 | −6.43 | −2.03 | −3.83 | <0.001 | −0.11 | |
Adaptive Performance ← Age | −0.03 | 0.06 | −0.15 | 0.08 | −0.6 | 0.546 | −0.02 | ||
Adaptive Performance ← Gender | −0.41 | 1.32 | −3.04 | 2.15 | −0.31 | 0.757 | −0.01 |
Effects | Label | B b | SE | 95% CI c | z | p | β d | H | |
---|---|---|---|---|---|---|---|---|---|
LL | UL | ||||||||
Indirect Effect PMIE vs. SMT recall a to Adaptive Performance through Burnout | a*b*d*f | −0.23 | 0.07 | −0.4 | −0.11 | −3.05 | 0.002 | −0.01 | H5 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Burnout | i | −4.3 | 1.12 | −6.43 | −2.03 | −3.83 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Burnout | i + a*b*d*f | −4.53 | 1.12 | −6.67 | −2.24 | −4.03 | <0.001 | −0.11 | |
Indirect Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | a*b*c*g | −0.34 | 0.1 | −0.55 | −0.18 | −3.54 | <0.001 | −0.01 | H7 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | i | −4.3 | 1.12 | −6.43 | −2.03 | −3.83 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Moral Learning | i + a*b*c*g | −4.64 | 1.13 | −6.77 | −2.37 | −4.11 | <0.001 | −0.12 | |
Indirect Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | a*b*e*h | −0.32 | 0.09 | −0.53 | −0.17 | −3.46 | 0.001 | −0.01 | H6 |
Direct Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | i | −4.3 | 1.12 | −6.43 | −2.03 | −3.83 | <0.001 | −0.11 | |
Total Effect PMIE vs. SMT recall to Adaptive Performance through Work Satisfaction | i + a*b*e*h | −4.62 | 1.13 | −6.75 | −2.36 | −4.1 | <0.001 | −0.11 | |
Indirect Effect PMIE vs. SMT recall to Burnout | a*b*d | 0.69 | 0.16 | 0.41 | 1.04 | 4.3 | <0.001 | 0.04 | H5 |
Direct Effect PMIE vs. SMT recall to Burnout | k | 3.35 | 0.77 | 1.79 | 4.81 | 4.34 | <0.001 | 0.19 | |
Total Effect PMIE vs. SMT recall to Burnout | k + a*b*d | 4.04 | 0.73 | 2.55 | 5.42 | 5.53 | <0.001 | 0.23 | |
Indirect Effect PMIE vs. SMT recall to Work Satisfaction | a*b*e | −0.46 | 0.1 | −0.68 | −0.29 | −4.59 | <0.001 | −0.04 | H6 |
Direct Effect PMIE vs. SMT recall to Work Satisfaction | j | −1.83 | 0.48 | −2.77 | −0.89 | −3.81 | <0.001 | −0.16 | |
Total Effect PMIE vs. SMT recall to Work Satisfaction | j + a*b*e | −2.3 | 0.46 | −3.2 | −1.4 | −5.03 | <0.001 | −0.21 |
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Gherman, M.A.; Arhiri, L.; Holman, A.C.; Soponaru, C. The Moral Impact of the COVID-19 Pandemic on Nurses’ Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic Psychological Needs. Int. J. Environ. Res. Public Health 2022, 19, 7645. https://doi.org/10.3390/ijerph19137645
Gherman MA, Arhiri L, Holman AC, Soponaru C. The Moral Impact of the COVID-19 Pandemic on Nurses’ Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic Psychological Needs. International Journal of Environmental Research and Public Health. 2022; 19(13):7645. https://doi.org/10.3390/ijerph19137645
Chicago/Turabian StyleGherman, Mihaela Alexandra, Laura Arhiri, Andrei Corneliu Holman, and Camelia Soponaru. 2022. "The Moral Impact of the COVID-19 Pandemic on Nurses’ Burnout, Work Satisfaction and Adaptive Work Performance: The Role of Autobiographical Memories of Potentially Morally Injurious Events and Basic Psychological Needs" International Journal of Environmental Research and Public Health 19, no. 13: 7645. https://doi.org/10.3390/ijerph19137645