Understanding Moral Injury and Its Predictors among Chinese Physicians

Abstract

BACKGROUND: Moral injury - the betrayal of one's moral and professional values - is a negative factor affecting physicians' wellbeing, however, few studies have examined moral injury and its predictors in healthcare professionals. This study aimed to determine the prevalence and predictors of moral injury in Chinese physicians. METHODS: This study was a cross-sectional survey conducted from September 14 to October 27, 2023, in mainland China. A total of 549 physicians completed the online self-administered questionnaire through the WeChat app. The 10-item Moral Injury Symptom Scale-Health Professional (MISS-HP) was used to assess the severity of moral injury symptoms, and the Moral Injury Events Scale (MIES) was used to measure exposure to potentially morally injurious events (PMIEs). RESULTS: The results of the study showed a mean score of 42.07 (SD=13.67) for the ten-item MISS-HP，the prevalence of moral injury among the physicians was 31.6%. The multiple linear regression identified five main predictors of moral injury: exposure to PMIEs, poor job satisfaction, lack of organizational support, witnessing patient suffering or death, and mental health needs. CONCLUSIONS: The findings contribute to the understanding of risk factors for moral injury among physicians and highlight the importance of intervening to help mitigate the risk factors. This is because moral injury can negatively affect the wellbeing of healthcare professionals, which in turn affects the stability of the healthcare team and the quality of care.