Moral sensitivity, moral resilience and compassion fatigue among geriatric services and management interns: the mediating roles of moral courage and professional identity

Background Compassion fatigue among geriatric services and management interns affects their career choices within the eldercare sector and exacerbates workforce shortages. While sociopsychological factors have been studied, the ethical dimension—particularly the role of moral sensitivity—remains underexplored. This study investigates the associations of moral sensitivity and moral resilience with compassion fatigue in Chinese geriatric services and management interns, including potential indirect associations through moral courage and professional identity. Methods A quantitative, cross-sectional study was conducted. Using convenience sampling, we recruited 371 geriatric services and management interns from four public junior colleges in Hunan and Guizhou Provinces, China, between November and December 2024. The data collection instruments included the Compassion Fatigue Short Scale, Revised Moral Sensitivity Questionnaire, Moral Courage Scale, Rushton Moral Resilience Scale, and Professional Identity Scale. Statistical analyses were performed using SPSS 22.0 for descriptive and preliminary analyses, and Amos 23.0 for structural equation modeling. Results The modified model demonstrated excellent fit indices ( χ 2 /df = 1.225, AGFI = 0.980, IFI = 0.998, TLI = 0.994, CFI = 0.998, NFI = 0.990, RMSEA = 0.025). Moral sensitivity was directly and positively associated with compassion fatigue ( β = 0.136, p = 0.011). Meanwhile, moral sensitivity showed a significant negative indirect association with compassion fatigue via the sequential pathway of moral courage and professional identity ( β = −0.050, 95% CI [−0.091 to −0.024], p = 0.001). Its total effect was not statistically significant ( β = 0.006, p = 0.891). Additionally, moral resilience had a direct negative association with compassion fatigue ( β = −0.230, p = 0.001), as well as an indirect negative association via professional identity ( β = −0.142, 95% CI [−0.197 to −0.095], p = 0.001). Conclusion Moral sensitivity showed both direct positive and indirect negative associations with compassion fatigue, while the total effect was not statistically significant. Moral resilience showed both direct and indirect negative associations with compassion fatigue. These findings suggest that moral courage, moral resilience, and professional identity warrant further investigation as potential targets for educational support among geriatric services and management interns. Longitudinal and intervention studies are needed to clarify these relationships and evaluate their practical implications.