The Effect of Moral Injury on the Sense of Occupational Calling among Healthcare Personnel: The Mediating Role of Assertiveness and the Moderating Roles of Ethical Leadership and Self-Compassion
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 19 (1404),
25 September 2025
,
Page 1-11
https://doi.org/10.22037/mej.v19i.52019
Abstract
Background and Aim: Occupational calling, as one of the most vital sources of motivation in the healthcare system, can be influenced by ethical tensions. This study aimed to investigate the relationship between moral injury and sense of occupational calling by explaining the mediating role of assertiveness and the moderating roles of ethical leadership and self-compassion among healthcare personnel at the Health Deputy of Fasa University of Medical Sciences.
Methods: This study is applied research with a descriptive-correlational study design. The study population consisted of healthcare personnel working at the Health Deputy of Fasa University of Medical Sciences in 2025, of whom 217 were included through the convenience sampling method. Data were collected using questionnaires assessing moral injury (Mantri et al, 2020), sense of occupational calling (Pardelan et al, 2022), assertiveness (Gambrill & Richey, 1975), ethical leadership (Yang et al, 2016) and self-compassion (Raes et al, 2011). The psychometric properties of the instruments were presented in the Methods section. Data analysis and hypothesis testing were analyzed using Structural Equation Modeling (SEM) and the Partial Least Squares (PLS) method in Smart PLS 3 software.
Ethical Considerations: In this study, by citing the references used, the ethical principle of scientific confidentiality and the intellectual property of authors’ rights were adhered to. Other principles of scientific ethics, including confidentiality and privacy of participants, were also observed.
Results: The findings indicated that moral injury had a significant negative effect on sense of occupational calling (p<0.001). The mediating role of assertiveness was also confirmed (p<0.001), indicating that moral injury decreases the sense of occupational calling by weakening individuals’ ability to express themselves assertively. Findings related to the moderating role also showed that both ethical leadership (p<0.001) and self-compassion (p<0.001), as protective factors, significantly moderated the destructive effects of moral injury and sense of occupational calling. Specifically, higher levels of self-compassion were associated with a weaker negative effect of moral injury on sense of occupational calling. The research model explained 58.4% of the variance in the sense of occupational calling.
Conclusion: According to findings, the professional identity and sense of occupational calling of healthcare personnel in the health system require a comprehensive approach. Improving psychological skills such as self-expression and self-compassion, along with promoting ethical leadership styles, can act as a factor against moral injury and prevent occupational alienation of personnel in healthcare settings.
- Moral Injury
- Occupational Calling
- Assertiveness
- Ethical Leadership
- Self-Compassion
- Healthcare Personnel
How to Cite
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