A Study of Moral Distress, Moral Injury and Post-Traumatic Stress for Nurses

The goal of this descriptive study is to examine levels of moral distress (MD), moral injury (MI), & post-traumatic stress (PTS) levels among nursing staff at Mayo Clinic. The main questions this study aims to answer are:

1. Determine the levels of MD, MI, and PTS symptoms experienced by nurses who participate in the study. 2. Evaluate differences in MD, MI, and PTS symptoms by setting, specialties, and geographic locations. 3. Examine demographic and professional characteristics that are associated with high levels of MD, MI and PTS.

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Key information

Conditions

Moral Injury Behavior Mental Disorders Moral Distress Nurse Health Nurse Well-being Nurses Personal Satisfaction Post-traumatic Stress Psychological Well-Being Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Trauma and Stressor Related Disorders Wellbeing Wellness Wellness, Psychological

Sex eligibility

All sexes

Study type

Observational

Primary location

Mayo Clinic, Phoenix, Arizona, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Mayo Clinic Department of Nursing Staff including:

Registered nurses
Licensed practical nurses
Nursing support staff (including roles such as patient care assistants, patient care specialists, medical assistants, and nurse technicians)

Exclusion criteria

Social workers
Chaplains
Unit coordinators
Other staff who do not support direct patient care but are within the nursing department
Other employees outside the Department of Nursing

Treatment and study plan

Surveys

Other

Participants will complete an electronic survey containing the Measure of Moral Distress- Healthcare Professionals (MMD-HP), Moral Injury Outcome Scale (MIOS) including functional outcome measures adapted from the Brief Inventory of Psychosocial Functioning, The PCL-5 Checklist for DSM-5 (Post-Traumatic Stress Disorder (PSTD) Checklist for the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)) (PCL-5), and the Well-Being Index (WBI), additionally including a demographic questionnaire with wellbeing questions.

Primary outcomes

Measure of Moral Distress-Healthcare Professionals (MMD-HP) Score

Time frame: Baseline

The MMD-HP (Measure of Moral Distress-Healthcare Professionals) is a 27-item moral distress scale. A composite score is computed for items 1 - 25 and is obtained by multiplying the frequency scores (0 = Never to 4 = Very Frequently scale) and the distress scores (0 = None to 4 = Very Distressing scale) for each item; the products of these can range from 0 - 16. Higher scores indicate a greater deal of moral distress.
Moral Injury Outcome Scale (MIOS) score

Time frame: Baseline

The Moral Injury Outcome Scale (MIOS) is a 14-item self-reported survey divided into two subscales-shame-related and trust-violation related. Both the shame and trust-violated subscales are seven items per subscale. Respondents are asked to indicate how strongly they agree with each statement in the past month using a 5 point Likert scale where 0 = Strongly Disagree and 4 = Strongly Agree. The total score range for each subscale is 0 - 28, and the overall score range is 0 - 56. Symptom severity is categorized as follows: 14 - 28 indicates mild moral injury, 29 - 42 indicates moderate moral injury, and 35 - 56 indicates severe moral injury.
Post-Traumatic Stress Disorder (PCL-5) score

Time frame: Baseline

The PCL - 5 (Post-Traumatic Stress Disorder (PSTD) Checklist) is a 20-item self-reported survey that assesses the 20 DSM-5 symptoms of PTSD. Respondents are asked to indicate the frequency that each item occurs on a 5 point Likert scale where 0 = Not at All and 4 = Extremely. The total score is the sum of all 20 questions, with higher scores indicating a greater likelihood of PTSD.

Sponsors and collaborators

Lead sponsor

Mayo Clinic

Other

Collaborators

Mayo Clinic Center for Clinical and Translational Science (CCaTS)

Registry information

Official study title

Moral Distress, Moral Injury and Post-Traumatic Stress Among Mayo Clinic Nurses

Acronym: MDMIPTS

Important dates

Study start: 2026
Primary completion: 2026
Study completion: 2026
First posted: Mar 6, 2026
Registry last updated: Jun 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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