Abstract
Background: Licensed nurses working in long-term care facilities experience ethical challenges if not resolved can lead to moral distress. There is a lack of an English-language validated tool to adequately measure moral distress in the long-term care setting. Aims: To describe the modification and psychometric evaluation of the Moral Distress Questionnaire. Methods: Instrument development and psychometric evaluation. Internal consistency using Cronbach’s α to establish reliability was conducted using SPSS version 27.0 while SPSS Amos version 27.0 was used to perform a confirmatory factor analysis of the Moral Distress Questionnaire Participants: A national sample of US-licensed nurses who provided direct resident care in long-term care settings were recruited via a targeted sampling method using Facebook from 7 December 2020 to 7 March 2021. Ethical Consideration: The study was approved by the university’s human research protection program. Informed consent was provided to all participants. Results: A total of 215 participants completed the surveys. Confirmatory analysis indicated that the 21-item scale with a 4-factor structure for the Moral Distress Questionnaire model met the established criteria and demonstrates an acceptable model fit (CMIN/DF = 2.0, CFI = 0.82, TLI = 0.77, RMSEA = 0.07). Factor loadings for each item depict a moderate to a strong relationship (range 0.36–0.70) with the given underlying construct. Cronbach’s α coefficient was 0.87 for the overall scale and 0.60–0.74 for its subscales which demonstrate good reliabilities. Discussion: This is the first English-language validated tool to adequately measure moral distress in the long-term care setting experienced by US long-term care nurses. This reliable and well-validated tool will help identify moral distress situations experienced by US long-term care nurses. Conclusion: The modified 21-item English version of the Moral Distress Questionnaire is reliable tool that demonstrates good psychometric properties to validly measure sources of moral distress among direct resident care nurses.
Original language | English |
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Pages (from-to) | 789-802 |
Number of pages | 14 |
Journal | Nursing Ethics |
Volume | 30 |
Issue number | 6 |
Early online date | 1 Mar 2023 |
DOIs | |
Publication status | Published - Sept 2023 |
Keywords
- Moral distress questionnaire
- long-term care
- nurses
- factor analysis
- validity
- reliability
- NURSING-HOMES
- DYING PATIENTS
- FIT INDEXES
- SAMPLE-SIZE
- NURSES
- COLLABORATION
- RESIDENTS
- PREDICTORS
- CHALLENGES
- AUTONOMY