Understanding moral injury and its predictors among Chinese physicians

Area of Science:

• Medical Ethics
• Occupational Health
• Psychology

Background:

• Moral injury, defined as the betrayal of one's moral and professional values, negatively impacts physician wellbeing.
• Limited research exists on moral injury and its predictors among healthcare professionals.
• This study investigates the prevalence, associated factors, and predictors of moral injury in Chinese physicians.

Purpose of the Study:

• To explore the prevalence of moral injury among Chinese physicians.
• To identify factors associated with moral injury in this population.
• To determine the predictors of moral injury in Chinese physicians.

Main Methods:

• A cross-sectional online survey was conducted in mainland China from September 14 to October 27, 2023.
• 549 physicians completed self-administered questionnaires via WeChat.
• The 10-item Moral Injury Symptom Scale-Health Professional (MISS-HP) and the Moral Injury Events Scale (MIES) were used to assess moral injury symptoms and exposure to potentially morally injurious events (PMIEs), respectively.

Main Results:

• The mean MISS-HP score was 42.07 (SD = 13.67).
• The prevalence of moral injury among Chinese physicians was 31.6%.
• Key predictors identified through multiple linear regression included exposure to PMIEs, job satisfaction, lack of organizational support, witnessing patient suffering or death, and mental health needs.

Conclusions:

• Chinese physicians experience PMIEs and moral injury symptoms in clinical practice.
• Modifiable risk factors for moral injury were identified, emphasizing the need for systemic interventions.
• Healthcare institutions should implement peer-support networks, improve communication regarding workload, and establish ethics recognition systems to mitigate moral injury and protect healthcare worker wellbeing.