Moral sensitivity, moral injury, and compassion fatigue among nursing interns: A correlational study

Background: Moral sensitivity, moral injury, and compassion fatigue are critical factors affecting the mental health and professional development of nursing interns, which have been studied in recent years. Moral development and mental health of nursing interns directly impact the quality of nursing care and patient safety.Aim: To explore the relationship among moral sensitivity, compassion fatigue, and moral injury among nursing interns and to analyze the role of moral injury in the relationship between moral sensitivity and compassion fatigue among nursing interns.Design: A correlational study design was employed. From October 2024 to January 2025, 206 eligible full-time nursing interns were recruited from Xi'an Medical University, Shaanxi Province. Data collection involved demographic questionnaires, Moral Sensitivity Questionnaire, Moral Injury Symptom Scale-Healthcare Professionals version, and the Compassion Fatigue-Short Scale. The relationships between moral sensitivity, moral injury, and compassion fatigue were examined using Pearson's correlation coefficient. Statistical significance was determined by a p-value of 0.05 or below. The mediation effect analysis was performed using the bootstrap method with 5000 bootstrap values. Data analysis was conducted using SPSS 27.0 and STATA 18.0.Ethical Considerations: This study was approved by Xi'an Medical University (XYLS2025001). The researchers ensured that participants were fully informed about the study's purpose and guaranteed that non-participation or withdrawal would not adversely affect their academic or internship outcomes. Informed consent was obtained from all participants.Results: There was a positive correlation between moral sensitivity and moral injury (r = 0.783, p < .001), and a positive correlation between moral sensitivity and compassion fatigue (r = 0.869, p < .001). The findings indicated a positive correlation between moral injury and compassion fatigue (r = 0.644, p < .001). The relationship between moral sensitivity and compassion fatigue was fully mediated by moral injury (β = 1.707, 95% CI: 1.252-2.162).Conclusion: Future studies could explore strategies to mitigate the adverse impact of moral sensitivity and moral injury on compassion fatigue among nursing interns.