Mobile-Based Resilience Intervention for Moral Injury, Compassion Fatigue, and Distress in ICU Nurses

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).