Burnout and Moral Injury in Healthcare Workers: An Observational Study in a Romanian Chronic Care Hospital.

BACKGROUND/

OBJECTIVES

Healthcare workers in chronic care hospitals are vulnerable to psychosocial risks such as burnout and moral injury due to prolonged patient exposure and limited institutional support. This study assessed the prevalence of burnout and moral injury among staff at the Chronic Diseases Hospital of Sebiș, Romania, and examined their associations with perceived stress and managerial support.

METHODS

A cross-sectional study was conducted between October 2022 and October 2024, including 62 healthcare workers (physicians, nurses, and auxiliary staff). Participants completed a sociodemographic survey, the Maslach Burnout Inventory (MBI), the Moral Injury Symptom Scale-Health Professional (MISS-HP), and additional items on perceived stress and institutional support. Statistical analysis included descriptive statistics, group comparisons, correlation matrices, and logistic regression.

RESULTS

High emotional exhaustion (MBI-EE ≥ 27) was reported by 45.2% of participants, with the highest rates among nurses (50%) and auxiliary staff (45.5%). Mean moral injury scores were moderate (mean = 5.3), with elevated levels observed in nurses and auxiliary staff. Pearson correlation analysis revealed no strong linear associations between burnout dimensions and moral injury. Logistic regression did not identify emotional exhaustion, perceived stress, or support as significant predictors of high moral injury.

CONCLUSIONS

Burnout and moral injury are prevalent but appear to be partially dissociated in this Romanian chronic care setting. Moral injury may arise from contextual ethical pressures beyond general occupational strain. Interventions should focus on ethical climate, institutional responsiveness, and peer-based moral support to enhance staff resilience.