Modified Moral Distress Scale (MDS-11): Validation Study Among Italian Nurses

Area of Science:

• Nursing
• Healthcare Ethics
• Psychometrics

Background:

• Moral distress (MD) significantly impacts healthcare professionals and organizations.
• A validated instrument for assessing MD in Italian nurses was previously lacking.

Purpose of the Study:

• To validate a brief instrument for assessing moral distress (MD) among Italian nurses.
• The study adapted the Corley's Moral Distress Scale (MDS) for the Italian context.

Main Methods:

• Content and cultural validity were assessed for the modified MDS.
• Psychometric analysis, including exploratory factor analysis (EFA), was conducted on data from 347 nurses.
• Construct validity was evaluated to ensure the scale accurately measures MD.

Main Results:

• The modified MDS comprises 11 items, revealing a two-dimensional structure: futility and potential damage.
• Futility relates to feelings of powerlessness in clinical situations.
• Potential damage reflects distress from tolerating or performing perceived abusive clinical actions.
• Higher levels of MD correlated with increased likelihood of burnout among nurses.

Conclusions:

• The modified 11-item MDS demonstrates strong psychometric properties, validating its use for assessing moral distress in Italian nurses.
• This reliable instrument facilitates monitoring of nurse distress and contributes to the well-being of healthcare workers.
• The findings underscore the importance of addressing moral distress to support the nursing community.