Moral distress in long-term care questionnaire modification and psychometric evaluation

Area of Science:

• Nursing Ethics
• Healthcare Professional Well-being
• Psychometric Validation

Background:

• Licensed nurses in long-term care facilities frequently encounter ethical challenges.
• Unresolved ethical issues can escalate to moral distress, impacting nurse well-being.
• A validated English-language tool is needed to measure moral distress specifically in long-term care.

Purpose of the Study:

• To modify and psychometrically evaluate the Moral Distress Questionnaire (MDQ).
• To establish the reliability and validity of an English version of the MDQ for long-term care settings.

Main Methods:

• Instrument development and psychometric evaluation of the MDQ.
• Internal consistency reliability assessed using Cronbach's alpha.
• Confirmatory factor analysis conducted using SPSS Amos.

Main Results:

• A 21-item, 4-factor model of the MDQ demonstrated acceptable fit.
• Factor loadings indicated moderate to strong relationships between items and constructs.
• The overall scale achieved a Cronbach's alpha of 0.87, with subscales ranging from 0.60-0.74, indicating good reliability.

Conclusions:

• The modified 21-item English MDQ is the first validated tool for measuring moral distress in US long-term care nurses.
• The questionnaire exhibits good psychometric properties and reliability.
• This validated tool will assist in identifying moral distress experienced by nurses in long-term care settings.