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.
Healthcare Professionals working on Psychiatric Facilities in the PACA Region
Absence of consent
Healthcare Professionals working on Psychiatric Facilities in the PACA Region affiliated with the Psynovia network
Other
Prospective
Self-Questionnaires for Healthcare Workers
Other interventionHealth workers will be invited to complete an online self-questionnaire
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"
Moral Injury Events Scale
Minimum score = 11, Maximum score = 66 Higher average scores indicate greater intensity of experience
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
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.
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.
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Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
Lead sponsor
Direction Générale de l'Offre de Soins
Collaborator
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