Moral Injury in French Healthcare Workers (MI-PRO)

April 13, 2026 updated by: Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

Healthcare professionals are facing an escalating crisis, with burnout rates ranging between 40% and 60% and a growing intention to leave the profession, affecting one in five physicians and one in four nurses in the coming years. While current interventions focused on individual resilience, such as mindfulness, peer support, and workload management, have been promoted as solutions, they have failed to bring about systemic improvements. This raises the question of whether other factors, such as Moral Injury, play a key role in this crisis. Moral Injury is an emerging concept that highlights the profound misalignment between healthcare workers' professional values and the reality of their practice, often exacerbated by organizational and economic constraints.

The objective of this study is to describe the manifestations of Moral Injury among healthcare professionals in France. By establishing the first large-scale assessment of Moral Injury among healthcare professionals in France, this study aims to identify key organizational and personal risk factors contributing to this phenomenon. The use of Structural Equation Modeling will help build a robust theoretical model that clarifies the underlying mechanisms of Moral Injury and its interactions with broader health issues. The findings will support the development of targeted interventions focused on systemic organizational changes to improve healthcare workers' well-being and guide public health policies.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Healthcare professionals are facing an escalating crisis, with burnout rates ranging between 40% and 60% and a growing intention to leave the profession, affecting one in five physicians and one in four nurses in the coming years. While current interventions focused on individual resilience, such as mindfulness, peer support, and workload management, have been promoted as solutions, they have failed to bring about systemic improvements. This raises the question of whether other factors, such as Moral Injury, play a key role in this crisis. Moral Injury is an emerging concept that highlights the profound misalignment between healthcare workers' professional values and the reality of their practice, often exacerbated by organizational and economic constraints.

The primary objective of this study is to describe the manifestations of Moral Injury among healthcare professionals in France. Secondary objectives include the psychometric validation of a French-language Moral Injury scale, the analysis of organizational and individual determinants of Moral Injury, and the structural modeling of underlying mechanisms.

This nationwide cross-sectional survey will be conducted electronically, reaching participants through healthcare institutions, professional societies, social networks, and a snowball dissemination strategy. Data collection will include standardized scales such as the Moral Injury Inventory for Healthcare Professionals, the Moral Injury Events Scale (MIES), the Maslach Burnout Inventory (MBI), and the EuroQol 5-Dimensions (EQ-5D) for quality of life, as well as ad hoc questions designed to explore additional systemic and professional challenges. A rigorous psychometric validation of the Moral Injury scale will be performed, followed by Structural Equation Modeling (SEM) to analyze the complex relationships between Moral Injury and other factors such as burnout, depression, and anxiety.

By establishing the first large-scale assessment of Moral Injury among healthcare professionals in France, this study aims to identify key organizational and personal risk factors contributing to this phenomenon. The use of Structural Equation Modeling will help build a robust theoretical model that clarifies the underlying mechanisms of Moral Injury and its interactions with broader health issues. The findings will support the development of targeted interventions focused on systemic organizational changes to improve healthcare workers' well-being and guide public health policies.

Study Type

Interventional

Enrollment (Estimated)

3073

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • France
    • Var
      • Toulon, Var, France, 83100
        • Recruiting
        • Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer
        • Contact:
        • Principal Investigator:
          • Laurent BOYER, Pr

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthcare workers

Exclusion Criteria:

  • Absence of consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Healthcare workers
All health professionals working in metropolitan France and the French overseas departments and territories
Other: Self-Questionnaires for Healthcare Workers
Health workers will be invited to complete an online self-questionnaire.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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"
One point : baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Moral Injury Events Scale
Time Frame: One point : baseline
Minimum score = 11, Maximum score = 66 Higher average scores indicate greater intensity of experience
One point : baseline
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
One point : baseline
EuroQol 5-Dimensions (EQ-5D)
Time Frame: One point : baseline
Scores range from -0.59 to 1, where 1 is the best possible health status.
One point : baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

Investigators

  • Study Director: Laurent BOYER, Pr, CEReSS

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 19, 2025

Primary Completion (Estimated)

May 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

April 7, 2025

First Submitted That Met QC Criteria

April 7, 2025

First Posted (Actual)

April 13, 2025

Study Record Updates

Last Update Posted (Actual)

April 14, 2026

Last Update Submitted That Met QC Criteria

April 13, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024-CHITS-019
  • 2024-a02449-38 (Other Identifier: ID-RCB number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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