Abstract

Background: Healthcare professionals globally grapple with profound occupational stressors. In resource-constrained settings like Nigeria, systemic challenges may exacerbate moral injury (the distress from violating one’s moral code) and job dissatisfaction, yet their combined impact on doctors’ mental health remains understudied.
Objective: This study aimed to determine the prevalence and interrelationship of moral injury, job dissatisfaction, and psychiatric morbidity among doctors in a major Nigerian tertiary hospital.
Methods: In a cross-sectional design, 200 doctors from Ahmadu Bello University Teaching Hospital, Zaria, were assessed using the Moral Injury Symptom Scale-Healthcare Professionals, the Generic Job Satis faction Scale, and modules of the MINI International Neuropsychiatric Interview (version 7.0) for depression, generalized anxiety disorder, and posttraumatic stress disorder. Multistage sampling was employed, and data were analyzed using chi-square tests and logistic regression.
Results: The prevalence of moral injury was 81.5%, job dissatisfaction 74.0%, and psychiatric morbidity 53.5% (comprising depression 37.0%, generalized anxiety disorder 11.5%, and posttraumatic stress disorder 5.0%). Logistic regression identified moral injury (OR = 4.98, 95% CI: 2.21–11.23), job dissatisfaction (OR = 6.34, 95% CI: 2.88–13.97), junior professional rank (OR = 2.89, 95% CI: 1.27–6.61), excessive
workload (OR = 3.52, 95% CI: 1.64–7.54), and lack of recognition (OR = 2.71, 95% CI: 1.21–6.05) as significant independent correlates of psychiatric morbidity.
Conclusion: Nigerian doctors in this setting exhibit high levels of moral injury, job dissatisfaction, and psychiatric morbidity, which are strongly interrelated. Multifaceted institutional interventions targeting ethical strain, working conditions, and mental health support are critical for workforce preservation and patient care quality.

Key words: Depression, Generalised Anxiety Disorder, Job Satisfaction, Moral Injury, Posttraumatic Stress Disorder