Healthcare professionals' identity conflict in ethically-charged situations: an investigation of individual and socio-ethical dynamics

In ethically-charged situations, such as End-of-Life circumstances, healthcare professionals may face identity conflict of moral nature due to incongruent values belonging to their multiple identities, e.g. professional and religious identities. Such conflict can significantly influence healthcare professionals' psychological outcomes, their practice and the overall quality of the healthcare service. However, despite these critical consequences, how identity conflict emerges, unfolds and affects doctors and nurses remains mostly unexplored. The overarching aim of this thesis is to advance the understanding of individual and socio-ethical dynamics of identity conflict. This aim is addressed through a mixed-method approach developed in three papers: a propositional paper, in which a narrative review is conducted; a qualitative paper, in which an inductive investigation based on semi-structured interviews is carried out; a quantitative paper, in which a mediated-moderation, multilevel analysis is run, implementing a two-time-lagged, questionnaire-based, design. This thesis extends the literature on identity conflict in four ways: (1) by conceptually integrating and explaining multiple individual and socio-ethical dynamics associated with identity conflict in a comprehensive and theoretically-justified model; (2) by providing an in-depth understanding of individual-level identity conflict dynamics, through the incorporation of novel ethical virtue-based decision-making approaches able to account for professional and religious values, emotions and interpersonal processes; (3) by exploring healthcare professionals' psychological and behavioural responses to identity conflict; (4) by sheding light on the extent to which individual and socio-ethical forces can affect identity conflict dynamics, thus filling a methodological gap in the identity literature regarding the implementation of multilevel approaches in identity research