Moral Injury Study Among Healthcare Professionals in Psychiatric Facilities in the PACA Region (MI-PSY)

June 8, 2026 updated by: Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

A Mixed Epidemiological Study of Moral Injury 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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Observational

Enrollment (Estimated)

2688

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 Contact Backup

Study Locations

  • France
      • Toulon, France
        • Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer
        • Contact:
        • Principal Investigator:
          • Nadège BOURVIS, MD

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

Sampling Method

Non-Probability Sample

Study Population

Healthcare Professionals working on Psychiatric Facilities in the PACA Region affiliated with the Psynovia network

Description

Inclusion Criteria:

  • Healthcare Professionals working on Psychiatric Facilities in the PACA Region

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Healthcare workers in psychiatry
All healthcare Professionals working in Psychiatric Facilities in the PACA Region 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
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.
One point : Baseline
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.
One point : Baseline
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.
One point : Baseline
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.
One point : Baseline
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.
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

Collaborators

Direction Générale de l'Offre de Soins

Investigators

  • Study Director: Nadège BOURVIS, MD, Centre Hospitalier Intercommunal Toulon La Seyne sur Mer
  • Study Chair: Laurent BOYER, MD, Aix Marseille Université

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 (Estimated)

July 1, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

June 2, 2026

First Submitted That Met QC Criteria

June 2, 2026

First Posted (Actual)

June 8, 2026

Study Record Updates

Last Update Posted (Actual)

June 10, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025-CHITS-012
  • 2026-A00514-47 (Other Identifier: Id-RCB)

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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