Development and evaluation of a moral distress scale

Area of Science:

• Nursing Research
• Psychometrics
• Healthcare Ethics

Background:

• Nurses frequently encounter ethical dilemmas in daily practice.
• Limited validated instruments exist to measure moral distress in nursing.
• Moral distress impacts nursing practice and job satisfaction.

Purpose of the Study:

• To develop and evaluate the psychometric properties of a new instrument to measure moral distress in nurses.
• To provide a reliable tool for assessing moral distress in clinical settings.
• To understand the prevalence and contributing factors of moral distress among nurses.

Main Methods:

• Methodological research design utilizing a convenience sample of 214 nurses.
• Development of the Moral Distress Scale (MDS) based on established theories and empirical research.
• Utilized a 7-point Likert format for 32 items, with higher scores indicating greater distress.

Main Results:

• The Moral Distress Scale (MDS) demonstrated reliability and validity.
• Mean scores indicated moderately high levels of moral distress among participants.
• Inadequate staffing was identified as the item with the highest mean score for moral distress.
• Factor analysis identified three key dimensions: individual responsibility, acting against patient best interest, and deception.
• No demographic or professional variables were found to be associated with moral distress levels.
• Fifteen percent of nurses reported resigning from a position due to moral distress.

Conclusions:

• The developed Moral Distress Scale (MDS) is a reliable and valid instrument for measuring moral distress in nurses.
• Findings highlight the significant impact of inadequate staffing on nurse moral distress.
• The study provides valuable insights into the nature and measurement of moral distress in the nursing profession.