Validation of the Moral Injury Outcome Scale in Canadian health care workers

Moral injury (MI), characterized by distress stemming from exposure to events that transgress one's moral beliefs, has gained prominence as a focal point of study in military and Veteran populations. In recent years, researchers and clinicians have acknowledged that MI carries substantial significance within health care settings. However, existing measures of MI may not adequately address the experiences of health care workers. The aim of this study was to evaluate the psychometric properties of a more recent measure of MI, the Moral Injury Outcome Scale (MIOS), which has been previously validated in military personnel, for use in Canadian health care workers (n = 786). The evaluation included its factorial, convergent, discriminant, and concurrent validity, measurement invariance, and internal consistency reliability. Results showed that the MIOS demonstrated a two-factor structure that was invariant at the configural, metric, and scalar level when compared with Canadian Veterans. Lastly, the MIOS showed strong convergent, discriminant, and concurrent validity. Overall, our findings revealed that the MIOS possesses robust psychometric properties. (PsycInfo Database Record (c) 2025 APA, all rights reserved).