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

NCT07631741 | Not Yet Recruiting

• 2 other identifiers: 2025-CHITS-0122026-A00514-47
• Study Type: observational
• Target: 2,688
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Moral Injury

Keywords

Moral Injury; Burnout; Healthcare Professionals; Psychiatry

Outcome Measures

Primary Outcomes (1)

• Moral Injury Inventory for Healthcare Professionals

  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 Outcomes (7)

• Moral Injury Events Scale

  One point : Baseline

• Maslach Burnout Inventory

  One point : Baseline

• Copenhagen Psychosocial Questionnaire

  One point : Baseline

• Team Psychological Safety on 7 points

  One point : Baseline

• Turnover Intention Scale-6

  One point : Baseline

Study Arms (1)

Healthcare workers in psychiatry

All healthcare Professionals working in Psychiatric Facilities in the PACA Region territories

Other: Self-Questionnaires for Healthcare Workers

Interventions

Self-Questionnaires for Healthcare Workers OTHER

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

Healthcare workers in psychiatry

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

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

You may qualify if:

• Healthcare Professionals working on Psychiatric Facilities in the PACA Region

You may not qualify if:

• Absence of consent

Sponsors & Collaborators

• Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer: lead
• Direction Générale de l'Offre de Soins: collaborator

Study Sites (1)

Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

Toulon, France

Location

Related Publications (15)

• 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.

  PMID: 39216090 BACKGROUND

• Papazian L, Hraiech S, Loundou A, Herridge MS, Boyer L. High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis. Intensive Care Med. 2023 Apr;49(4):387-400. doi: 10.1007/s00134-023-07025-8. Epub 2023 Mar 27.

  PMID: 36971792 BACKGROUND

• Boyer L, Wu AW, Fernandes S, Tran B, Brousse Y, Nguyen TT, Yon DK, Auquier P, Lucas G, Boussat B, Fond G. Exploring the fear of clinical errors: associations with socio-demographic, professional, burnout, and mental health factors in healthcare workers - A nationwide cross-sectional study. Front Public Health. 2024 Jun 26;12:1423905. doi: 10.3389/fpubh.2024.1423905. eCollection 2024.

  PMID: 38989124 BACKGROUND

• Fond G, Smith L, Tran B, Lucas G, Nguyen TT, Yon DK, Boyer L. Unmasking the triad of burnout, absenteeism, and poor sleep among healthcare workers during the third wave of COVID-19 pandemics. Results from the national AMADEUS study. J Affect Disord. 2024 Jun 15;355:247-253. doi: 10.1016/j.jad.2024.03.157. Epub 2024 Mar 28.

  PMID: 38554883 BACKGROUND

• Fond G, Smith L, Boussat B, Lucas G, Yon DK, Tran B, Nguyen TT, Stubbs B, Boyer L. Association between physical activity and health in healthcare professionals : Results from the nationwide AMADEUS survey. Rev Epidemiol Sante Publique. 2023 Dec;71(6):102183. doi: 10.1016/j.respe.2023.102183. Epub 2023 Nov 7.

  PMID: 37944193 BACKGROUND

• Coelho J, Lucas G, Micoulaud-Franchi JA, Tran B, Yon DK, Taillard J, D'Incau E, Philip P, Boyer L, Fond G. Sleep timing, workplace well-being and mental health in healthcare workers. Sleep Med. 2023 Nov;111:123-132. doi: 10.1016/j.sleep.2023.09.013. Epub 2023 Sep 21.

  PMID: 37769583 BACKGROUND

• Fond G, Lucas G, Boyer L. Health-promoting work schedules among nurses and nurse assistants in France: results from nationwide AMADEUS survey. BMC Nurs. 2023 Aug 3;22(1):255. doi: 10.1186/s12912-023-01403-9.

  PMID: 37537611 BACKGROUND

• Coelho J, Taillard J, Bernard A, Lopez R, Fond G, Boyer L, Lucas G, Alla F, Buysse DJ, Wallace ML, Verdun-Esquer C, Geoffroy PA, d'Incau E, Philip P, Micoulaud-Franchi JA. Emotional Exhaustion, a Proxy for Burnout, Is Associated with Sleep Health in French Healthcare Workers without Anxiety or Depressive Symptoms: A Cross-Sectional Study. J Clin Med. 2023 Feb 27;12(5):1895. doi: 10.3390/jcm12051895.

  PMID: 36902682 BACKGROUND

• Fond G, Fernandes S, Lucas G, Greenberg N, Boyer L. Depression in healthcare workers: Results from the nationwide AMADEUS survey. Int J Nurs Stud. 2022 Nov;135:104328. doi: 10.1016/j.ijnurstu.2022.104328. Epub 2022 Jul 23.

  PMID: 35952535 BACKGROUND

• Lucas G, Colson S, Boyer L, Gentile S, Fond G. Work environment and mental health in nurse assistants, nurses and health executives: Results from the AMADEUS study. J Nurs Manag. 2022 Oct;30(7):2268-2277. doi: 10.1111/jonm.13599. Epub 2022 Apr 19.

  PMID: 35332585 BACKGROUND

• Lucas G, Colson S, Boyer L, Gentile S, Fond G. [Influence of the work environment on burn-out and depression in nurses]. Rev Infirm. 2022 Jan;71(277):34-35. doi: 10.1016/j.revinf.2021.11.011. Epub 2021 Dec 2. French.

  PMID: 35090629 BACKGROUND

• Lucas G, Colson S, Boyer L, Inthavong K, Haller PH, Lancon C, Auquier P, Gentile S, Fond G. Risk factors for burnout and depression in healthcare workers: The national AMADEUS study protocol. Encephale. 2022 Jun;48(3):247-253. doi: 10.1016/j.encep.2021.06.001. Epub 2021 Oct 16.

  PMID: 34666893 BACKGROUND

• Fond G, Bourbon A, Lancon C, Boucekine M, Micoulaud-Franchi JA, Auquier P, Boyer L. Psychiatric and psychological follow-up of undergraduate and postgraduate medical students: Prevalence and associated factors. Results from the national BOURBON study. Psychiatry Res. 2019 Feb;272:425-430. doi: 10.1016/j.psychres.2018.12.174. Epub 2018 Dec 31.

  PMID: 30611959 BACKGROUND

• Kansoun Z, Boyer L, Hodgkinson M, Villes V, Lancon C, Fond G. Burnout in French physicians: A systematic review and meta-analysis. J Affect Disord. 2019 Mar 1;246:132-147. doi: 10.1016/j.jad.2018.12.056. Epub 2018 Dec 18.

  PMID: 30580199 BACKGROUND

• Fond G, Bourbon A, Micoulaud-Franchi JA, Auquier P, Boyer L, Lancon C. Psychiatry: A discipline at specific risk of mental health issues and addictive behavior? Results from the national BOURBON study. J Affect Disord. 2018 Oct 1;238:534-538. doi: 10.1016/j.jad.2018.05.074. Epub 2018 Jun 15.

  PMID: 29936392 BACKGROUND

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic; Burnout, Psychological

Interventions

Health Personnel

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders; Stress, Psychological; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Health Care Facilities Workforce and Services

Study Officials

• Nadège BOURVIS, MD

  Centre Hospitalier Intercommunal Toulon La Seyne sur Mer

  STUDY DIRECTOR

• Laurent BOYER, MD

  Aix Marseille Université

  STUDY CHAIR

Central Study Contacts

Sophie LAFOND

CONTACT

483772062; sophie.lafond@ch-toulon.fr

Nadège BOURVIS, MD

CONTACT

nadege.bourvis@ch-toulon.fr

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 2, 2026
• First Posted: June 8, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027
• Last Updated: July 7, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)