An interventional study of Behavioral in Moral Injury, sponsored by Alexandria University. Not yet recruiting at 1 site in Egypt. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-27.
Sponsored by Alexandria University · Not applicable, Interventional, and Prevention
Critical care nurses are routinely exposed to high acuity, mortality, end-of-life decisions, and long rotating shifts, which can lead to moral injury, compassion fatigue (burnout and secondary traumatic stress), and psychological distress. This randomized controlled trial will test the effectiveness of ICU Resilience, an 8-week, self-paced, Arabic-language mobile-based workplace resilience intervention, in reducing these outcomes among full-time nurses working in the intensive care units of Beni-Suef University Hospitals, Egypt.
One hundred sixty nurses will be randomly allocated 1:1 to the intervention or a control arm. The intervention is grounded in Conservation of Resources theory and an integrated cognitive-reappraisal and psycho-spiritual resilience framework, organized around psychological, emotional, social, and professional resources. Each weekly module includes a micro-learning video, an audio-guided exercise, an interactive digital tool, and a daily one-minute micro-practice, covering psychoeducation, mindfulness and somatic regulation, cognitive reappraisal, self-compassion, meaning-making, social support, practical coping, and relapse prevention. Control participants receive usual workplace orientation and routine hospital support and are offered the app after the final assessment.
Moral injury, burnout, secondary traumatic stress, psychological distress, and resilience will be measured with self-report scales at baseline, immediately after the intervention (week 8), and at one-month follow-up (week 12).
2,291 studies on the registry are indexed under Stress Disorders, Post-Traumatic; 559 are open to participants now.
This study's planned enrollment of 160 is above the median of 70 across 1,903 interventional studies indexed under Stress Disorders, Post-Traumatic.
Browse Stress Disorders, Post-Traumatic studies →Alexandria University is the lead sponsor of 596 studies on the registry; 134 are open to participants now.
Of its 13 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
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Exclusion Criteria:
Participants use the ICU Resilience mobile application for 8 consecutive weeks (one module per week plus daily one-minute micro-practices) in addition to usual workplace orientation and routine hospital support.
Behavioral: Behavioral
Participants receive usual workplace orientation and routine hospital support, with no access to the app during the trial. They complete the same assessments at the same time points and are offered the app after the follow-up assessment.
Eight weekly modules delivered individually and asynchronously through a web-based mobile application in Arabic, with no facilitator. Each module includes a micro-learning video (5-7 minutes), an audio-guided exercise (3-10 minutes), an interactive digital tool, and a daily 1-minute micro-practice. Weekly topics: psychoeducation; mindfulness and somatic regulation; cognitive reappraisal; self-compassion and emotion regulation; meaning-making and values; social support; practical coping and shift micro-drills; integration and relapse prevention. Grounded in Conservation of Resources theory and a cognitive-reappraisal and psycho-spiritual resilience framework. Automated reminders prompt module and daily practice completion.
Moral injury: Moral Injury Symptom Scale-Healthcare Professionals (MISS-HP) total score
Moral injury symptoms measured with the Moral Injury Symptom Scale-Healthcare Professionals (MISS-HP; Mantri et al., 2020), a 10-item self-report questionnaire. Items are rated from 1 (strongly disagree) to 10 (strongly agree); items 5, 6, 7, and 10 are reverse-coded. Minimum total score 10, maximum 100. Higher scores indicate greater moral injury (worse outcome). Unit of measure: score on a scale.
Time frame: Baseline (T0), immediately after the 8-week intervention (T1, week 8), and one-month follow-up (T2, week 12)
urnout: Professional Quality of Life Scale version 5 (ProQOL-5), Burnout subscale score
Burnout measured with the 10-item Burnout subscale of the Professional Quality of Life Scale version 5 (ProQOL-5; Stamm, 2009), one of two subscales used to operationalize compassion fatigue. Items are rated from 1 (never) to 5 (very often) for the past 30 days; items 1, 4, 15, 17, and 29 are reverse-scored. Minimum subscale score 10, maximum 50. Higher scores indicate greater burnout (worse outcome). Unit of measure: score on a scale.
Time frame: Baseline (T0), immediately after the 8-week intervention (T1, week 8), and one-month follow-up (T2, week 12)
Secondary traumatic stress: Professional Quality of Life Scale version 5 (ProQOL-5), Secondary Traumatic Stress subscale score
Secondary traumatic stress measured with the 10-item Secondary Traumatic Stress subscale of the Professional Quality of Life Scale version 5 (ProQOL-5; Stamm, 2009), one of two subscales used to operationalize compassion fatigue. Items are rated from 1 (never) to 5 (very often) for the past 30 days. Minimum subscale score 10, maximum 50. Higher scores indicate greater secondary traumatic stress (worse outcome). Unit of measure: score on a scale.
Time frame: Baseline (T0), immediately after the 8-week intervention (T1, week 8), and one-month follow-up (T2, week 12)
Psychological distress: Kessler Psychological Distress Scale (K10) total score
Non-specific psychological distress (anxiety and depressive symptoms) measured with the Kessler Psychological Distress Scale (K10; Kessler et al., 2002), a 10-item self-report questionnaire covering the preceding four weeks. Items are rated from 1 (none of the time) to 5 (all of the time). Minimum total score 10, maximum 50. Higher scores indicate greater psychological distress (worse outcome). Unit of measure: score on a scale.
Time frame: Baseline (T0), immediately after the 8-week intervention (T1, week 8), and one-month follow-up (T2, week 12)
Resilience: 10-item Connor-Davidson Resilience Scale (CD-RISC-10) total score
Resilience measured with the 10-item Connor-Davidson Resilience Scale (CD-RISC-10; Campbell-Sills and Stein, 2007), a self-report questionnaire covering the past month. Items are rated from 0 (not true at all) to 4 (true nearly all the time). Minimum total score 0, maximum 40. Higher scores indicate greater resilience (better outcome). Unit of measure: score on a scale.
Time frame: Baseline (T0), immediately after the 8-week intervention (T1, week 8), and one-month follow-up (T2, week 12)
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Stress Disorders, Post-Traumatic →