Moral Injury in French Healthcare Workers

NCT ID: NCT06926296

Last Updated: 2025-12-02

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 3073 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-19
• Study Completion Date: 2026-11-30

Brief Summary

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.

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.

Conditions

Moral Injury

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Healthcare workers

All health professionals working in metropolitan France and the French overseas departments and territories

Group Type: OTHER

Self-Questionnaires for Healthcare Workers

Intervention Type: OTHER

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

Interventions

Self-Questionnaires for Healthcare Workers

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

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Healthcare workers

Exclusion Criteria

• Absence of consent

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Laurent BOYER, Pr

Role: STUDY_DIRECTOR

CEReSS

Locations

Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

Toulon, Var, France

Site Status: RECRUITING

Countries

France

Central Contacts

Sophie LAFOND

Role: CONTACT

sophie.lafond@ch-toulon.fr

0483772062 ext. +33

Facility Contacts

Sophie LAFOND

Role: primary

sophie.lafond@ch-toulon.fr

0483772062 ext. +33

References

Boyer L, Fond G, Tran B, Llorca PM, Duclos A. The hidden crisis: Moral injury among French healthcare workers. J Epidemiol Popul Health. 2024 Dec;72(6):202780. doi: 10.1016/j.jeph.2024.202780. Epub 2024 Oct 19.

Reference Type: BACKGROUND

PMID: 39427511 (View on PubMed)

Dean W, Morris D, Llorca PM, Talbot SG, Fond G, Duclos A, Boyer L. Moral Injury and the Global Health Workforce Crisis - Insights from an International Partnership. N Engl J Med. 2024 Sep 5;391(9):782-785. doi: 10.1056/NEJMp2402833. Epub 2024 Aug 31. No abstract available.

Reference Type: BACKGROUND

PMID: 39216090 (View on PubMed)

Other Identifiers

2024-a02449-38

Identifier Type: OTHER

Identifier Source: secondary_id

2024-CHITS-019

Identifier Type: -

Identifier Source: org_study_id