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NCT Number: NCT07631741

Moral Injury Study Among Healthcare Professionals in Psychiatric Facilities in the PACA Region

Healthcare professionals working in psychiatric settings face demanding working conditions characterized by high rates of burnout and specific constraints, such as the deprivation of patients' liberty. *Moral Injury* (MI), a relatively recent concept, extends beyond burnout by focusing on the distress arising from ethical conflicts and the dissonance between professional values and the realities of clinical practice. Although the concept has begun to emerge from a theoretical perspective, particularly in the United States, it remains largely unknown in France and has yet to be investigated in psychiatric settings at the international level.

The hypothesis is that MI plays a central role in healthcare professionals' psychological distress and contributes to the major recruitment and retention crisis affecting public psychiatric institutions. This crisis is reflected, for example, in a 40% vacancy rate for hospital physician positions in public facilities, with particularly acute shortages in child and adolescent psychiatry. The demographic crisis in child and adolescent psychiatry is unprecedented, marked by a 30% decline in the workforce over the past decade and projections suggesting a further 50% reduction within the next ten years. At the same time, mental health disorders among adolescents-particularly suicide attempts among girls-have increased substantially since the COVID-19 pandemic.

This study aims to explore the organizational, individual, and systemic factors associated with Moral Injury in order to better understand and prevent this form of professional suffering.

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Key information

Conditions

Moral Injury Behavior Behavioral Symptoms Burnout, Psychological Mental Disorders Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Stress, Psychological Trauma and Stressor Related Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

Toulon, France

Location contact

Nadège BOURVIS, MD

PRINCIPAL_INVESTIGATOR

Sophie LAFOND

CONTACT

[email protected]

483772062 ext. +33

About this study

This study is a regional cross-sectional observational survey conducted electronically through online questionnaires administered via the LimeSurvey platform of Aix-Marseille University, which is certified for Health Data Hosting (HDS). The coordinating center will distribute the survey to institutions affiliated with the Psynovia Psychiatry Federation.

Participation in the study is voluntary, and data collection is pseudonymized. Participants may withdraw from the study at any time without consequence. Completion of the questionnaires is expected to take approximately 20 minutes.

No intervention involving the study population is planned as part of this research. Upon completion of the survey, participants who feel the need to discuss their psychological well-being (e.g., stress, anxiety, sleep disturbances, depressive symptoms, or burnout) will be encouraged to seek support from a healthcare professional, such as their occupational health service and/or primary care physician.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Healthcare Professionals working on Psychiatric Facilities in the PACA Region

Exclusion criteria

  • Absence of consent

Treatment and study plan

Self-Questionnaires for Healthcare Workers

Other

Health workers will be invited to complete an online self-questionnaire

Primary outcomes

  1. Moral Injury Inventory for Healthcare Professionals

    Time frame: One point : Baseline

    An overall score out of 100 will be created for the inventory, where a high score indicates a high level of "Moral Injury"

Secondary outcomes

  1. Moral Injury Events Scale

    Time frame: One point : Baseline

    Minimum score = 11, Maximum score = 66 Higher average scores indicate greater intensity of experience

  2. Maslach Burnout Inventory

    Time frame: One point : Baseline

    3 scores calculated in this inventory Burnout : minimum score = 0, maximum score = 63, Higher average scores indicate greater intensity of burnout Depersonalization : minimum score = 0, maximum score = 35, Higher average scores indicate greater intensity of depersonalization Personal fulfillment : minimum score = 0, maximum score = 56, Higher average scores indicate greater intensity of personal fulfillment

  3. Copenhagen Psychosocial Questionnaire

    Time frame: One point : Baseline

    Assesses psychosocial working conditions across domains such as job demands, work organization, social relations, leadership, and well-being. Scores are typically scaled from 0 to 100, with higher scores indicating either more favorable conditions (e.g., social support, job satisfaction) or greater psychosocial risk (e.g., stress, emotional demands), depending on the domain assessed.

  4. Team Psychological Safety on 7 points

    Time frame: One point : Baseline

    Scale measures the extent to which team members feel safe to speak up, ask questions, admit mistakes, and express concerns without fear of negative consequences. Items are rated on a 7-point Likert scale, with higher scores indicating greater perceived psychological safety within the team.

  5. Turnover Intention Scale-6

    Time frame: One point : Baseline

    Scale assesses an employee's intention to leave their current job or organization. Items are rated on a Likert scale, with higher scores indicating a stronger intention to quit and a greater risk of staff turnover.

  6. Patient Health Questionnaire-4

    Time frame: One point : Baseline

    This is a brief screening tool combining two items for anxiety and two for depression, used to assess overall psychological distress. Higher total scores indicate greater levels of anxiety and depressive symptoms, with established cut-offs used to categorize severity from minimal to severe distress.

  7. World Health Organization Well-Being Index - 5

    Time frame: One point : Baseline

    Assesses short self-reported measure of current psychological well-being, assessing positive mood, vitality, and general interest in life over the past two weeks. Scores range from 0 to 25 (or 0 to 100 when transformed), with higher scores indicating better well-being and lower scores suggesting reduced well-being or possible depression.

Study contacts

Contact information is provided by the study sponsor or research team.

Nadège BOURVIS, MD

CONTACT

[email protected]

Sophie LAFOND

CONTACT

[email protected]

483772062 ext. +33

Sponsors and collaborators

Lead sponsor

Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

Other

Collaborators

  • Direction Générale de l'Offre de Soins

Registry information

Official study title

A Mixed Epidemiological Study of Moral Injury Among Healthcare Professionals in Psychiatric Facilities in the PACA Region

Acronym: MI-PSY

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 8, 2026
Registry last updated
Jul 7, 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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