Global Research Across Countries on Moral Distress and Moral Injury Among Health Care Professionals (2006–2025): A Bibliometric Study of Ethical and Health-Related Research Trends
摘要
Moral distress and moral injury have become important concepts for understanding the moral experiences of health care professionals in ethically challenging clinical contexts. In this study, a comprehensive bibliometric analysis of research focusing upon the combination of both moral distress and moral injury among health care professionals published between 2006 and 2025 was conducted via the Web of Science Core Collection. The aim was to examine publication trends, collaboration patterns, core journals, disciplinary distributions, and research hotspots in this field. Bibliometric analyses were performed via VOSviewer, CiteSpace, Pajek, and Scimago Graphica. A total of 1,180 publications were included in the analysis. The results revealed a steady increase in research output over time, with rapid growth following the COVID-19 pandemic. Research activity was concentrated in a limited number of countries and institutions, with the USA contributing the greatest number of publications and demonstrating a central position in international collaboration networks. Nursing, clinical medicine, psychology, and ethics were the main disciplinary foundations of this research field. Keyword and co-citation analyses indicated that moral distress has remained the dominant research focus, while moral injury has gained increasing attention in recent years, particularly in relation to high-intensity care settings and psychological outcomes. Overall, this bibliometric analysis provides an overview of the knowledge structure and evolving themes of research on moral distress and moral injury among health care professionals. Several limitations regarding this bibliometric study are acknowledged.