What is it about?

Moral injury (MI) among physicians has recently attracted health professionals. MI may occur when clinicians feel their ability to deliver care is compromised by the systems (e.g., insurance, reimbursement, electronic health record) being implemented by hospitals, clinics, and medical practices . To our knowledge, no research has yet examined moral injury among physicians and nurses in mainland China. The present study sought to explore the prevalence of MI and its association with clinician mental health and burnout in a national physician/nurse sample using an online survey. We hypothesized that MI is prevalent among physicians and nurses during this COVID-19 pandemic and is associated with a higher level of psychological burden and more severe burnout.

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Why is it important?

Protecting healthcare professionals against workplace violence, psychological distress, and clinician burnout has been a global challenge in recent years, especially during this time of the COVID-19 pandemic . WHO has defined health as “a dynamic state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity” (WHO, 1998). Studies on the moral/spiritual health of HCPs are few, although beginning to receive some attention in the literature. To our knowledge, this is the first quantitative study to explore moral injury symptoms in a large sample of HCPs during the COVID-19 pandemic.


MI symptoms are correlated with higher clinician burnout, greater psychological distress, and lower level of subjective well-being. Strategies shown to be effective for MI in former military personnel might be used to address burnout and mental health problems in front line healthcare workers tasked with treating those with and without COVID-19 disease. Our findings provide a profile of HCPs who are at risk for MI symptoms and may help to identify those at risk of downstream effects in terms of psychological health and patient safety.

zhizhong wang
Guangdong Medical University

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This page is a summary of: Moral injury in Chinese health professionals during the COVID-19 pandemic., Psychological Trauma Theory Research Practice and Policy, February 2022, American Psychological Association (APA), DOI: 10.1037/tra0001026.
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