Badolamenti Sondra, Fida Roberto, Biagioli Valentina, Caruso Rosario, Zaghini Francesco, Sili Alessandro, Rea Teresa
Scala sullo Stress Morale Modificata (MDS-11): Studio di Validazione tra gli Infermieri Italiani.
Lecturer in Organizational Behavior, University of East Anglia, Norwich, United Kingdom.
Prof Inferm. 2017 Oct-Dec;70(4):238-248. doi: 10.7429/pi.2017.704238.
Moral distress (MD) has significant implications on individual and organizational health. However there is a lack of an instrument to assess it among Italian nurses.
The main aim of this study was to validate a brief instrument to assess MD, developed from the Corley's Moral Distress Scale (MDS).
The modified MDS scale was subjected to content and cultural validity. The scale was administered to 347 nurses. Psychometric analysis were performed to assess construct validity.
The scale consists of 11 items, investigating MD in nursing practice in different clinical settings. The dimensionality of the scale was investigated through exploratory factor analysis (EFA), which showed a two-dimensional structure labeled futility and potential damage. The futility refers to feelings of powerlessness and ineffectiveness in some clinical situations; the potential damage dimension captures feelings of powerlessness when nurses are forced to tolerate or perform perceived abusive clinical proceedings. Nurses who experienced higher MD, were more lilely to experience burnout.
The modified MDS showed good psychometric properties, and it is valid and reliable for assessing moral distress among Italian nurses. Hence, the modified MDS allows to monitor the distress experienced by nurses and it is an important contribution to the scientific community and all those dealing with well-being of health workers.
道德困扰（MD）对个人和组织健康具有重大影响。然而，意大利护士中缺乏评估道德困扰的工具。
本研究的主要目的是验证一种从科利道德困扰量表（MDS）衍生而来的用于评估道德困扰的简短工具。
对修改后的MDS量表进行内容效度和文化效度评估。该量表施用于347名护士。进行心理测量分析以评估结构效度。
该量表由11个项目组成，调查不同临床环境中护理实践中的道德困扰。通过探索性因素分析（EFA）研究量表的维度，结果显示其具有一个二维结构，分别标记为徒劳感和潜在伤害。徒劳感指在某些临床情况下的无力感和无效感；潜在伤害维度体现了护士被迫容忍或进行被认为是虐待性的临床程序时的无力感。经历较高道德困扰的护士更有可能出现职业倦怠。
修改后的MDS显示出良好的心理测量特性，对于评估意大利护士的道德困扰是有效且可靠的。因此，修改后的MDS有助于监测护士所经历的困扰，这对科学界以及所有关注医护人员福祉的人来说是一项重要贡献。
