Exploratory and Confirmatory Factor Analysis of the Moral Injury Exposure and Symptom Scale-Civilian in Secure Mental Healthcare Workers

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Initial research shows moral injury is prevalent among secure mental healthcare staff, yet there are a limited tools developed for healthcare populations. This study examined the psychometric properties of the Moral Injury Exposure and Symptoms Scale-Civilian (MIESS-C) with mental health professionals. Exploratory and confirmatory factor analyses (N=322) revealed a two-factor model: “moral self-transgressions” and “other and organizational betrayal.” Items related to others’ transgressions were excluded due to cross-loading. The subscales demonstrated excellent internal consistency and convergent validity with psychological distress measures. The MIESS-C is partially supported for assessing moral injury in this context, though caution is advised.