Moral distress questionnaire for clinical nurses: instrument development

Area of Science:

• Nursing Research
• Healthcare Ethics
• Psychometrics

Background:

• Growing interest in healthcare professionals' ethical dilemmas and associated stress.
• Ethical issues in healthcare are complex and often overlooked.
• Need for tools to capture moral distress experiences.

Purpose of the Study:

• To develop and psychometrically test a culture-sensitive moral distress questionnaire for nurses.
• To capture nurses' experiences of ethical challenges in diverse work settings.
• To provide a reliable and valid instrument for assessing moral distress.

Main Methods:

• Two-phase study: qualitative for themes, quantitative for questionnaire development.
• A 15-item questionnaire was designed and administered to 179 nurses.
• Data collected in 2006 from nurses in various work settings.

Main Results:

• Factor analysis identified three moral distress factors: staff relationships, resource limitations, and time pressure.
• Significant differences found between community and hospital nurses regarding relationships and time pressure factors.
• The questionnaire demonstrated statistically significant test-retest reliability, indicating measure stability.

Conclusions:

• The developed questionnaire is a reliable and valid measure of moral distress within the Israeli cultural context.
• The instrument effectively captures key sources of moral distress for nurses.
• Further validation in different cultural settings is recommended.