Balancing work and family responsibilities is challenging for working mothers, particularly those with caregiving duties. The present study investigates the relationship between work-family conflict (WFC) and moral injury, focusing on the potential moderating role of moral resilience. Italian working mothers (N = 285), either with preschool children or caring responsibilities for elderly parents and adolescent/young adult children, completed measures of WFC, moral injury, and moral resilience. Results indicated an association between work-family conflict (WFC) and moral injury, with moral resilience attenuating this relationship. Specifically, at higher levels of moral resilience, the relationship between WFC and moral injury was weaker. This protective mechanism was consistent across different caregiving groups. These findings enhance understanding of the complex psychological experiences of working mothers and emphasize the importance of interventions, such as flexible work policies and moral resilience training, to provide effective support. Practical implications, study limitations, and directions for future research are discussed.
AllenT. D.FrenchK. A.DumaniS.ShockleyK. M. (2020). A cross-national meta-analytic examination of predictors and outcomes associated with work–family conflict. Journal of Applied Psychology, 105(6), 539–576. https://doi.org/10.1037/apl0000442
2.
AllenT. D.HerstD. E.BruckC. S.SuttonM. (2000). Consequences associated with work-to-family conflict: A review and agenda for future research. Journal of Occupational Health Psychology, 5(2), 278–308. https://doi.org/10.1037/1076-8998.5.2.278
3.
AmstadF. T.MeierL. L.FaselU.ElferingA.SemmerN. K. (2011). A meta-analysis of work–family conflict and various outcomes with a special emphasis on cross-domain versus matching-domain relations. Journal of Occupational Health Psychology, 16(2), 151–169. https://doi.org/10.1037/a0022170
4.
BarbaranelliC. (2007). Analisi dei dati. Tecniche multivariate per la ricerca psicologica e sociale (2nd ed.). LED.
5.
BianchiS. M.MilkieM. A. (2010). Work and family research in the first decade of the 21st century. Journal of Marriage and Family, 72(3), 705–725. https://doi.org/10.1111/j.1741-3737.2010.00726.x
6.
BorelliJ. L.NelsonS. K.RiverL. M.BirkenS. A.Moss-RacusinC. (2017). Gender differences in work-family guilt in parents of young children. Sex Roles, 76(5), 356–368. https://doi.org/10.1007/s11199-016-0579-0
7.
BronfenbrennerU. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
8.
Bureau of Labor Statistics. (2023, April 24). Employment characteristics of families - 2023 (USDL-24-0743). U.S. Department of Labor. Retrieved October 30, 2024, from. https://www.bls.gov/news.release/famee.nr0.htm
9.
BurkeR. J.GreenglassE. R. (1999). Work-family congruence and work-family concerns among nursing staff. Canadian Journal of Nursing Leadership, 12(2), 21–29. https://doi.org/10.12927/cjnl.1999.19074
CarlsonD. S.KacmarK. M.WilliamsL. J. (2000). Construction and initial validation of a multidimensional measure of work-family conflict. Journal of Vocational Behavior, 56(2), 249–276. https://doi.org/10.1006/jvbe.1999.1713
12.
CavagnisL.RussoC.DanioniF.BarniD. (2023). Promoting women’s well-being: A systematic review of protective factors for work–family conflict. International Journal of Environmental Research and Public Health, 20(21), 6992. https://doi.org/10.3390/ijerph20216992
ChaploS. D.KerigP. K.WainrybC. (2019). Development and validation of the moral injury scales for youth. Journal of Traumatic Stress, 32(3), 448–458. https://doi.org/10.1002/jts.22408
15.
CheungG. W.RensvoldR. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5
CurrierJ. M.HollandJ. M.Rojas-FloresL.HerreraS.FoyD. (2015). Morally injurious experiences and meaning in Salvadorian teachers exposed to violence. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 24–33. https://doi.org/10.1037/a0034092
18.
DeanW.TalbotS.DeanA. (2019). Reframing clinician distress: Moral injury not burnout. Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS, 36(9), 400–402.
19.
DingR.DardasA.WangL.WilliamsA. (2020). Evaluation of a caregiver-friendly workplace program intervention on the health of full-time caregiver employees: A time series analysis of intervention effects. Journal of Occupational and Environmental Medicine, 62(10), e548–e558. https://doi.org/10.1097/JOM.0000000000001980
20.
DuvanderA. Z.EllingsæterA. L. (2016). Cash for childcare schemes in the Nordic welfare states: Diverse paths, diverse outcomes. European Societies, 18(1), 70–90. https://doi.org/10.1080/14616696.2015.1124903
21.
EmslieC.HuntK. (2009). ‘Live to work’ or ‘work to live’? A qualitative study of gender and work–life balance among men and women in mid‐life. Gender, Work and Organization, 16(1), 151–172. https://doi.org/10.1111/j.1468-0432.2008.00434.x
22.
EpsteinE. G.HamricA. B. (2009). Moral distress, moral residue, and the crescendo effect. Journal of Clinical Ethics, 20(4), 330–342. https://doi.org/10.1086/JCE200920406
23.
FingermanK. L.PillemerK. A.SilversteinM.SuitorJ. J. (2012). The baby boomers’ intergenerational relationships. The Gerontologist, 52(2), 199–209. https://doi.org/10.1093/geront/gnr139
24.
FrankfurtS.FrazierP. (2016). A review of research on moral injury in combat veterans. Military Psychology, 28(5), 318–330. https://doi.org/10.1037/mil0000132
25.
FroneM. R.RussellM.CooperM. L. (1992). Antecedents and outcomes of work-family conflict: Testing a model of the work-family interface. Journal of Applied Psychology, 77(1), 65–78. https://doi.org/10.1037/0021-9010.77.1.65
26.
FroneM. R.YardleyJ. K.MarkelK. S. (1997). Developing and testing an integrative model of the work-family interface. Journal of Vocational Behavior, 50(2), 145–167. https://doi.org/10.1006/jvbe.1996.1577
27.
FryeN. K.BreaughJ. A. (2004). Family-friendly policies, supervisor support, work–family conflict, family–work conflict, and satisfaction: A test of a conceptual model. Journal of Business and Psychology, 19(2), 197–220. https://doi.org/10.1007/s10869-004-0548-4
28.
GallucciM. (2019). GAMLj: General analyses for linear models. Retrieved September 2, 2024, from. https://gamlj.github.io/
29.
GervaisR.MillearP. (2024). Women’s caring responsibilities as they age: Assessing the sandwich Generation’s satisfaction with life and well-being. Community, Work & Family, 1–22. https://doi.org/10.1080/13668803.2024.2364093
30.
GeurtsS. A.DemeroutiE. (2003). Work/non-work interface: A review of theories and findings. In SchabracqM. J.WinnubstJ. A. M.CooperC. L. (Eds.), The handbook of work and health psychology (2nd ed., pp. 279–312). Wiley.
31.
GoldenT. D. (2012). Altering the effects of work and family conflict on exhaustion: Telework during traditional and nontraditional work hours. Journal of Business and Psychology, 27(3), 255–269. https://doi.org/10.1007/s10869-011-9247-0
32.
GordonJ. R.PruchnoR. A.Wilson-GendersonM.MurphyW. M.RoseM. (2012). Balancing caregiving and work: Role conflict and role strain dynamics. Journal of Family Issues, 33(5), 662–689. https://doi.org/10.1177/0192513X11425322
33.
GreenhausJ. H.BeutellN. J. (1985). Sources of conflict between work and family roles. Academy of Management Review, 10(1), 76–88. https://doi.org/10.2307/258214
34.
GutekB. A.SearleS.KlepaL. (1991). Rational versus gender role explanations for work-family conflict. Journal of Applied Psychology, 76(4), 560–568. https://doi.org/10.1037/0021-9010.76.4.560
35.
HammerL. B.KossekE. E.AngerW. K.BodnerT.ZimmermanK. L. (2011). Clarifying work–family intervention processes: The roles of work–family conflict and family-supportive supervisor behaviors. Journal of Applied Psychology, 96(1), 134–150. https://doi.org/10.1037/a0020927
36.
HeinzeK. E.HansonG.HoltzH.SwobodaS. M.RushtonC. H. (2021). Measuring health care interprofessionals' moral resilience: Validation of the Rushton moral resilience scale. Journal of Palliative Medicine, 24(6), 865–872. https://doi.org/10.1089/jpm.2020.0328
37.
HinesS. E.ChinK. H.LevineA. R.WickwireE. M. (2020). Initiation of a survey of healthcare worker distress and moral injury at the onset of the COVID‐19 surge. American Journal of Industrial Medicine, 63(9), 830–833. https://doi.org/10.1002/ajim.23157
38.
HochschildA.MachungA. (2012). The second shift: Working families and the revolution at home. Penguin Books.
IresonR.SethiB.WilliamsA. (2018). Availability of caregiver-friendly workplace policies (CFWPs): An international scoping review. Health and Social Care in the Community, 26(1), e1–e14. https://doi.org/10.1111/hsc.12347
JinkersonJ. D. (2016). Defining and assessing moral injury: A syndrome perspective. Traumatology, 22(2), 122–130. https://doi.org/10.1037/trm0000069
43.
LachmanV. D. (2016). Ethics, law, and policy. Moral resilience: Managing and preventing moral distress and moral residue. Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses, 25(2), 121–124.
44.
LeeY.TangF. (2015). More caregiving, less working: Caregiving roles and gender difference. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 34(4), 465–483. https://doi.org/10.1177/0733464813508649
45.
LitzB. T.SteinN.DelaneyE.LebowitzL.NashW. P.SilvaC.MaguenS. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003
46.
LiuZ.HongL. (2023). Work–family conflict and mental health among Chinese female healthcare workers during the COVID-19 pandemic: The moderating effects of resilience. Healthcare, 11(12), 1696. https://doi.org/10.3390/healthcare11121696
47.
LoscalzoY.RaffagninoR.GonnelliC.GianniniM. (2019). Work–family conflict scale: Psychometric properties of the Italian version. Sage Open, 9(3), Article 2158244019861495. https://doi.org/10.1177/2158244019861495
48.
MannaV.ProcenteseF.Di NapoliI.ArcidiaconoC. (2021). Helpless mothers dropping out of the workplace: The Italian case of voluntary resignation. Qualitative Report, 26(4), 1179–1199. https://doi.org/10.46743/2160-3715/2021.4490
49.
MantriS.SongY. K.LawsonJ. M.BergerE. J.KoenigH. G. (2020). Moral injury and burnout in health care professionals during the COVID-19 pandemic. The Journal of Nervous and Mental Disease, 208(7), 603–606. https://doi.org/10.1097/NMD.0000000000001367
50.
MaunoS.KinnunenU.RuokolainenM. (2006). Exploring work-and organization-based resources as moderators between work–family conflict, well-being, and job attitudes. Work & Stress, 20(3), 210–233. https://doi.org/10.1080/02678370600999969
51.
MilkieM. A.PeltolaP. (1999). Playing all the roles: Gender and the work-family balancing act. Journal of Marriage and Family, 61(2), 476–490. https://doi.org/10.2307/353763
52.
MillerD. A. (1981). The ‘sandwich’ generation: Adult children of the aging. Social Work, 26(5), 419–423. https://doi.org/10.1093/sw/26.5.419
53.
MorettiG.CavagnisL.FluttiE.SilvestriS.TravainiG. V. (2025). Mental health issues in undercover police officers: A systematic literature search from a psychiatric perspective. Healthcare, 13(15), 1933. https://doi.org/10.3390/healthcare13151933
54.
NashW. P.Marino CarperT. L.MillsM. A.AuT.GoldsmithA.LitzB. T. (2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652. https://doi.org/10.7205/MILMED-D-13-00017
55.
NetemeyerR. G.BolesJ. S.McMurrianR. (1996). Development and validation of work-family conflict and family-work conflict scales. Journal of Applied Psychology, 81(4), 400–410. https://doi.org/10.1037/0021-9010.81.4.400
56.
NoheC.MeierL. L.SonntagK.MichelA. (2015). The chicken or the egg? A meta-analysis of panel studies of the relationship between work–family conflict and strain. Journal of Applied Psychology, 100(2), 522–536. https://doi.org/10.1037/a0038012
57.
NomaguchiK. M. (2006). Maternal employment, nonparental care, mother-child interactions, and child outcomes during preschool years. Journal of Marriage and Family, 68(5), 1341–1369. https://doi.org/10.1111/j.1741-3737.2006.00332.x
58.
NomaguchiK. M.MilkieM. A.BianchiS. M. (2005). Time strains and psychological well-being: Do dual-earner mothers and fathers differ?Journal of Family Issues, 26(6), 756–792. https://doi.org/10.1177/0192513X05277524
59.
OchiaiE. (2009). Care diamonds and welfare regimes in East and south-east Asian societies: Bridging family and welfare sociology. International Journal of Japanese Sociology, 18(1), 60–78. https://doi.org/10.1111/j.1475-6781.2009.01117.x
60.
PalenaN.CasoL.CavagnisL.GrecoA.VrijA. (2023). Exploring the relationship between personality, morality and lying: A study based on the Person-Centred Approach. Current Psychology, 42(24), 20502–20514. https://doi.org/10.1007/s12144-022-03132-9
61.
PutnickD. L.BornsteinM. H. (2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review: Developmental Review, 41, 71–90. https://doi.org/10.1016/j.dr.2016.06.004
62.
RichardsonN. M.LamsonA. L.SmithM.EaganS. M.ZvonkovicA. M.JensenJ. (2020). Defining moral injury among military populations: A systematic review. Journal of Traumatic Stress, 33(4), 575–586. https://doi.org/10.1002/jts.22553
63.
RiedelP. L.KrehA.KulcarV.LieberA.JuenB. (2022). A scoping review of moral stressors, moral distress and moral injury in healthcare workers during COVID-19. International Journal of Environmental Research and Public Health, 19(3), 1666. https://doi.org/10.3390/ijerph19031666
64.
RushtonC. H. (2016). Moral resilience: A capacity for navigating moral distress in critical care. AACN Advanced Critical Care, 27(1), 111–119. https://doi.org/10.4037/aacnacc2016275
RushtonC. H. (2023). Transforming moral suffering by cultivating moral resilience and ethical practice. American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses, 32(4), 238–248. https://doi.org/10.4037/ajcc2023207
RutkowskiL.SvetinaD. (2014). Assessing the hypothesis of measurement invariance in the context of large-scale international surveys. Educational and Psychological Measurement, 74(1), 31–57. https://doi.org/10.1177/0013164413498257
SpilgE. G.RushtonC. H.PhillipsJ. L.SaadM.GiffordW.GautamM.BhatlaR.EdwardsJ. D.QuiltyL.LeveilleC.RobillardR. (2022). The new frontline: Exploring the links between moral distress, moral resilience, and mental health in healthcare workers during the COVID-19 pandemic. BMC Psychiatry, 22(19), 19. https://doi.org/10.1186/s12888-021-03637-w
72.
TalbotS. G.DeanW. (2018). Physicians aren't 'burning out.' they're suffering from moral injury. Statistical News, 7(26), 18.
73.
The Jamovi Project. (2021). Jamovi (Version 2.2) [Computer software]. Retrieved September 2, 2024, from. https://www.jamovi.org
74.
ThomasL. T.GansterD. C. (1995). Impact of family-supportive work variables on work-family conflict and strain: A control perspective. Journal of Applied Psychology, 80(1), 6–15. https://doi.org/10.1037/0021-9010.80.1.6
75.
ValtortaR. R.BaldissarriC.PalenaN.VolpatoC. (2025). Agency attribution and biological dehumanisation: Preliminary evidence. Journal of Community & Applied Social Psychology, 35(5), Article e70146. https://doi.org/10.1002/casp.70146
76.
WeiH.WuB.ParkH.DengC. (2022). Is exercise good for all? Time- and strain-based work–family conflict and its impacts. The Journal of Social Psychology, 163(2), 230–247. https://doi.org/10.1080/00224545.2022.2111251
77.
WutT.LeeS.XuJ. (2022). Role of organizational resilience and psychological resilience in the workplace—internal stakeholder perspective. International Journal of Environmental Research and Public Health, 19(18), Article 11799. https://doi.org/10.3390/ijerph191811799
ZhangR. P.BowenP. (2021). Work-family conflict (WFC)–examining a model of the work-family interface of construction professionals. Safety Science, 144, Article 105469. https://doi.org/10.1016/j.ssci.2021.105469
