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Moral InjuryMI-PSYNCT07631741

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

An observational study of Moral Injury, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 1 site in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Moral Injury
What is being tested?
Self-Questionnaires for Healthcare Workers
How many people
2,688 participants
Where
1 siteFrance
Study dates
Jul 2026to Jan 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

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

Who may be able to join

  • Healthcare Professionals working on Psychiatric Facilities in the PACA Region

Who cannot join

  • Absence of consent

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Nadège BOURVIS, MD contact

nadege.bourvis@ch-toulon.fr

France1 site
  • Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

    Toulon

    Sophie LAFOND, 483772062 ext. +33, sophie.lafond@ch-toulon.fr

    Nadège BOURVIS, MD

Other trials in France

About this study

Official title: 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.

Read the 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.

Conditions
Moral Injury
Being tested
Self-Questionnaires for Healthcare Workers
Keywords
Moral Injury, Burnout, Healthcare Professionals, Psychiatry
Medical subject headings
Stress Disorders, Post-Traumatic, Burnout, Psychological

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Self-Questionnaires for Healthcare WorkersOther

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

Study groups in NCT07631741
Study groupRoleWhat they receive
Healthcare workers in psychiatryAll healthcare Professionals working in Psychiatric Facilities in the PACA Region territories
Receives: Other: Self-Questionnaires for Healthcare Workers

What is being measured

The primary outcome is the main question the study is designed to answer.

  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"

    Measured: One point : Baseline

Secondary outcomes (7)
  1. Moral Injury Events Scale

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

    Measured: One point : Baseline

  2. Maslach Burnout Inventory

    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

    Measured: One point : Baseline

  3. Copenhagen Psychosocial Questionnaire

    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.

    Measured: One point : Baseline

  4. Team Psychological Safety on 7 points

    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.

    Measured: One point : Baseline

  5. Turnover Intention Scale-6

    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.

    Measured: One point : Baseline

  6. Patient Health Questionnaire-4

    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.

    Measured: One point : Baseline

  7. World Health Organization Well-Being Index - 5

    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.

    Measured: One point : Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jun 2026
  2. Study startJul 2026 (estimated)
  3. Primary completionJan 2027 (estimated)
  4. Study completionJan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
2,688 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07631741
Sponsor's protocol ID
2025-CHITS-012
Other IDs
2026-A00514-47
Acronym
MI-PSY
Status last verified
Jul 2026
First submitted
2 Jun 2026
Last updated
7 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • 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.

    PubMed 39216090
  • 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.

    PubMed 36971792
  • 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.

    PubMed 38989124
  • 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.

    PubMed 38554883
  • 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.

    PubMed 37944193
  • 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.

    PubMed 37769583
  • 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.

    PubMed 37537611
  • 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.

    PubMed 36902682
  • 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.

    PubMed 35952535
  • 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.

    PubMed 35332585
  • 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.

    PubMed 35090629
  • 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.

    PubMed 34666893
  • 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.

    PubMed 30611959
  • 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.

    PubMed 30580199
  • 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.

    PubMed 29936392

Questions about this trial

What is this clinical trial studying?

An observational study of Moral Injury, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 7 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sophie LAFOND (483772062 ext. +33, sophie.lafond@ch-toulon.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Moral Injury Inventory for Healthcare Professionals (time frame: One point : Baseline). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07631741, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jul 2026.

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