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⚖️ MISS-HP Moral Injury

Moral Injury Symptom Scale - Healthcare Professionals
Ethical stress & moral injury screening
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Did You Know?

MISS-HP score ≥36 indicates clinically significant moral injury—affects 10-30% of healthcare professionals

Why This Assessment Matters

The Moral Injury Symptom Scale - Healthcare Professionals is a 10-item screening tool adapted from the military MISS-M for healthcare settings. It measures 10 dimensions of moral injury: betrayal, guilt, shame, moral concerns, religious struggle, loss of faith, loss of meaning, difficulty forgiving, loss of trust, and self-condemnation. Developed by Mantri et al. (2020) at Duke University during the COVID-19 pandemic.

✨ Key Benefits

  • Healthcare-specific — Adapted for physicians, nurses, and healthcare professionals
  • 10-item efficiency — 10-point visual analog scales per item, takes 5-10 minutes
  • Validated cutoff — Score ≥36 = 84% sensitivity, 93% specificity for significant distress
  • Convergent validity — Strong correlation with burnout (r=0.57) but distinct construct
  • Free to use — Available from Mantri et al. Journal of Religion and Health 2020

⚖️ Moral injury is not burnout—it's the deep soul wound from betrayal, ethical compromise, or witnessing harm. COVID-19 tripled moral injury prevalence in frontline workers. Chinese physicians show 31.6% prevalence of clinically significant moral injury. Unaddressed moral injury leads to PTSD, depression, and suicide risk. Measure it before it destroys your sense of purpose.

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Moral Injury Symptom Scale - Healthcare Professionals

Please answer all questions below.
1. I feel betrayed by leadership/administration in my healthcare organization
2. I feel guilt over things I did or failed to do in patient care situations
3. I feel ashamed of the things I have done or failed to do in my work
4. I am troubled by having witnessed or participated in care that goes against my moral values
5. I have religious or spiritual struggles related to my work experiences
6. I have lost my sense of religious or spiritual faith because of my work experiences
7. I have lost a sense of meaning and purpose in my life because of my work
8. I have difficulty forgiving myself for things that happened in my work
9. I have lost trust in leadership or colleagues because of work experiences
10. I condemn myself for what has happened in my professional work

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