Laura Arhiri

Background: Student mobility carries mental health and well-being risks, particularly when transition-related needs are hidden by formal student categories. Objective: This short communication examines Moldovan students with Romanian citizenship in Romanian higher education. Legally classified as domestic, they may undergo an international-like adjustment involving linguistic, cultural, academic, and relational transition. Methods: We analyzed semi-structured interviews with 24 such students using reflexive thematic analysis and interpreted them through an integrated lens of belonging uncertainty, minority stress, and transactional stress-coping models within a biopsychosocial framework. Four themes were generated: social stressors and belonging difficulties, including accent-based othering and withdrawal; academic and institutional stressors, including educational culture mismatch and help-seeking barriers; mental and physical health costs, including fear of failure, emotional exhaustion, and somatic symptoms; and mixed coping and support strategies. Results: What distinguishes these accounts from generic student adjustment appears to be their configuration: difference attributed to nationality rather than to socioeconomic or regional background, legal contingency, cross-system educational discontinuity, and the absence of any administrative category through which support might be triggered. Because such students are invisible to provision keyed to international status, screening and belonging-based support should be indexed to adjustment need rather than enrollment category, and directed at institutional conduct as well as individual coping. Conclusion: Hidden student mobility may constitute a distinct adjustment context in which substantial cross-border transition is obscured by domestic administrative status. Recognizing adjustment needs independently of formal enrolment categories may help institutions identify otherwise overlooked students and design more equitable, context-sensitive support.

Background: Nurses suffered an unprecedented number of potentially morally injurious events (PMIEs) during the COVID-19 pandemic. Their long-term associations with organizational well-being remain unknown. Research aim: We aimed to assess whether psychological basic need thwarting characteristic of nurses’ episodic memories of PMIEs from the pandemic, either enacted (self-PMIEs) or passively witnessed (other-PMIEs), explained unique burnout and turnover intentions variance 2 years after the events. Research design: We present findings of a quantitative, two-wave longitudinal study (2022, when the pandemic peaked, and 2024, post-pandemic), focusing on comparing the two waves. In 2022, participants were randomly assigned to self-report need-thwarting associated with memories of either self-PMIEs or other-PMIES (quasi-experimental design). During both waves, they filled in questionnaires for burnout, turnover intentions, work-related psychological need satisfaction and socio-demographic factors. Participants and research context: Through chain-referral methods, we purposively sampled 463 Romanian nurses working in hospitals at the peak of the pandemic in 2022, with 350 remaining in 2024. Ethical considerations: Ethical approval was granted by the faculty ethics committee. Participants were fully informed of the research purpose and their rights prior to both waves. Findings: Linear mixed models showed that need-frustration associated with memories of self-PMIEs (assessed in 2022) significantly predicted burnout and turnover intentions in 2024. For memories of other-PMIEs, the relationships became nonsignificant in 2024. Conclusions: Episodic memories of self-PMIEs continue to contribute to nurses’ burnout and turnover intentions 2 years after the events. Organizational efforts for fostering positive retrospective appraisals through counseling services are needed, along with creating a safe climate where ethical misdemeanors may be disclosed and processed without fear of sanctions.

Using moralization in anti-vaping public health messages as a persuasion strategy was recently recommended to address the current vaping epidemic. However, previous findings indicated this could lead to moralized attitudes in the general population, which can be very difficult to change and could severely affect social cohesion and distort risk perception. Since the safety and efficiency of using electronic cigarettes as smoking cessation devices are still being investigated, we conducted a cross-sectional, experimental study on a convenience sample of 612 Romanian never vapers, never smokers to assess how exposure to moralizing public health messages about vaping might influence their trust in future scientific results about this topic. Participants were randomized into six groups according to the type of message (“moral,” “immoral,” “neutral”) and the type of effects of vaping on smokers’ health, documented in a future fictitious study (“health benefits,” “health risks”). Results showed that the type of message moderated trust in future scientific results after controlling for participants’ general trust in science. When vaping was framed as immoral, trust in future scientific results showing health benefits was decreased, and vice versa. Implications are discussed for using moralization strategically in public health messaging to curtail or promote certain health behaviors.

The COVID-19 pandemic was a fertile ground for nurses’ exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses’ memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience sample of 634 Romanian nurses, we tested a conceptual model with PLS-SEM, finding adequate explanatory and predictive power. Memories of self- and other-PMIEs were uniquely associated with work engagement, burnout, and turnover intentions, compared to a control group. These relationships were mediated by the three basic psychological needs. Relatedness was more thwarted for memories of other-PMIEs, while competence and autonomy were more thwarted for memories of self-PMIEs. Perceived supervisor support weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, but not through burnout. Self-disclosure weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, and both burnout and work engagement. Our findings emphasize the need for different strategies in addressing the negative long-term effects of nurses’ exposure to self- and other-PMIEs, according to the basic psychological need satisfaction and type of wellbeing indicator.

Nurses have been frequently exposed to Potentially Morally Injurious Events (PMIEs) during the COVID-19 pandemic. Due to resource scarcity, they both perpetrated (self-PMIEs) and passively witnessed (other-PMIEs) moral transgressions toward the patients, severely violating their moral values. Our study investigated the impact of self- and other-PMIEs on work outcomes by exploring nurses’ episodic memories of these events and the basic psychological need thwarting associated with them. Using a quasi-experimental design, on a convenience sample of 463 Romanian nurses, we found that PMIEs memories were uniquely associated with burnout and turnover intentions, after controlling for socio-demographic characteristics, general basic psychological need satisfaction at work and other phenomenological characteristics. Both self- and other-PMIEs memories were need thwarting, with autonomy and competence mediating their differential impact on burnout, and with relatedness—on turnover intentions. Our findings emphasize the need for organizational moral repair practices, which should include enhancing nurses’ feelings of autonomy, relatedness and competence. Psychological counseling and psychotherapy should be provided to nurses to prevent their episodic memories of PMIEs to be (fully) integrated in autobiographical knowledge, because this integration could have severe consequences on their psycho-social function and occupational health, as well as on the organizational climate in healthcare institutions.

The COVID-19 pandemic resulted in unprecedented exposure to Potentially Morally Injurious Events (PMIEs) for nurses, in which they were both moral transgressors and moral victims, with deleterious consequences on their psycho-social health and functioning. Our experimental design compared memories of PMIEs with memories of severe moral transgressions (SMTs), in which participants were only moral transgressors. Drawing from Self-Determination Theory and research on moral auto-biographical episodic memories, we assessed a conceptual model describing the impact of recalling a single PMIE or SMT event on nurses’ burnout, work satisfaction and adaptive performance. Our convenience sample comprised 614 Romanian nurses, and data was analyzed with path analysis, general linear modelling, and t-tests. Findings showed that memories of PMIEs, compared to SMTs, were more autonomy thwarting, being associated with more controlled work motivation, less moral learning, higher burnout, less work satisfaction, and adaptive performance. Burnout, moral learning, and work satisfaction were significant mediators of the relationships between PMIE and SMT recall and, respectively, adaptive performance. Our results highlight the urgency for organizational practices of moral repair for nurses after the pandemic, along with interventions meant to increase their autonomy and self-determined work motivation.

Ageism in nursing is difficult to identify, prevent and combat. Using a mixed-method approach in two exploratory cross-sectional studies (N = 512), we brought support for a proposed conceptual difference between ageism toward older adults and ageism toward older patients which may facilitate the identification of ageism in healthcare settings. We also investigated whether nurses’ moral sensitivity could buffer the negative effect of socio-cognitive factors on ageism against older patients. Our findings supported our assumption, suggesting that fostering nurses’ moral sensitivity could be a promising new avenue to prevent and combat ageism in nurses, together with comprehensive gerontological education meant to decrease stereotyping and help nurses fulfill their roles of moral advocates against older patient discrimination.

This study explored the influence of healthcare ageism on nurses’ moral distress. Episodic interviews were conducted on 25 Romanian nurses in 2020. Thematic analysis revealed that all moral distress sources reported reflected macro-, meso- and micro-level ageism, benevolent and hostile, self- or other-directed, including stereotyping, prejudice, and discrimination of older patients. The COVID-19 pandemic-related ageist measures increased healthcare ageism and transformed nurses’ representations of older patients accordingly. Nurses felt moral conflict both when passively witnessing ageist acts and when perpetrating them to adhere to group norms, highlighting the need to combat ageism for both patients’ and nurses’ well-being.

Using e-cigarettes for smoking cessation is a controversial topic among health experts. Evidence suggests that vaping might have been moralized among the general public. Despite the detrimental consequences of moralizing health behaviors on social cohesion and health, some argue for using moralization strategically to prevent and combat vaping. We aim to add to the body of literature showing the dangers of moralization in health by proposing a person-centered approach to the moralization of anti-vaping attitudes. Our cross-sectional survey explores the moralization of anti-vaping attitudes and its predictors on a convenience sample of 348 Romanian never-vapers, before the final vote to severely restrict vaping. By fitting a hierarchical regression model on our data, we found support for a unique contribution of negative prototypes (β = 0.13) and opinions of vapers (β = 0.08) in predicting moralization, with significant contributions of piggybacking on moralized self-control, on moralized attitudes toward smoking and on sanctity/degradation, disgust, anger, harm to children, and gender. Together, these variables explained 56% of the variance of the moralization of anti-vaping attitudes. Our findings add to our knowledge of motivated moralization and advise against using moralization in health, suggesting that people may weaponize it to legitimize group dislike.