验证健康专业人员道德伤害症状和支持量表的德语版本（G-MISS-HP）及其与第二受害者现象的相关性。
Validation of the German Version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) and Its Correlation to the Second Victim Phenomenon.
机构信息
Institute for Infection Control and Infection Prevention, Health Care Association District of Constance, 78315 Konstanz, Germany.
Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany.
出版信息
Int J Environ Res Public Health. 2022 Apr 16;19(8):4857. doi: 10.3390/ijerph19084857.
INTRODUCTION
Comparable to second victim phenomenon (SVP), moral injury (MI) affects health professionals (HP) working in stressful environments. Information on how MI and SVP intercorrelate and their part in a psychological trauma complex is limited. We tested and validated a German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) instrument, screening for MI and correlated it with the recently developed German version of the Second Victim Experience and Support Tool (G-SVESTR) instrument, testing for SVP.
METHODS
After translating Moral Injury Symptom and Support Scale for Health Professionals (MISS-HP), we conducted a cross-sectional online survey providing G-MISS-HP and G-SVEST-R to HP. Statistics included Pearson's interitem correlation, reliability analysis, principal axis factoring and principal components analysis with Promax rotation, confirmatory factor and ROC analyses.
RESULTS
A total of 244 persons responded, of whom 156 completed the survey (33% nurses, 16% physicians, 9% geriatric nurses, 7.1% speech and language therapists). Interitem and corrected item-scale correlations did not measure for one item sufficiently. It was, therefore, excluded from further analyses. The nine-item score revealed good reliability (Guttman's lambda 2 = 0.80; Cronbach's alpha = 0.79). Factor validity was demonstrated, indicating that a three-factor model from the original study might better represent the data compared with our two-factor model. Positive correlations between G-MISS-HP and G-SVESTR subscales demonstrated convergent validity. ROC revealed sensitivity of 89% and specificity of 63% for G-MISS-HP using a nine-item scale with cutoff value of 28.5 points. Positive and negative predictive values were 62% and 69%, respectively. Subgroup analyses did not reveal any differences.
CONCLUSION
G-MISS-HP with nine items is a valid and reliable testing instrument for moral injury. However, strong intercorrelations of MI and SVP indicate the need for further research on the distinction of these phenomena.
简介
类似于第二受害者现象（SVP），道德伤害（MI）会影响在压力环境下工作的医疗保健专业人员（HP）。有关 MI 和 SVP 如何相互关联及其在心理创伤综合体中的作用的信息有限。我们测试并验证了一种德语版的健康专业人员道德伤害症状和支持量表（G-MISS-HP），用于筛查 MI，并将其与最近开发的德语版第二受害者经历和支持工具（G-SVESTR）进行了比较，用于检测 SVP。
方法
在翻译健康专业人员道德伤害症状和支持量表（MISS-HP）后，我们进行了一项横断面在线调查，向 HP 提供 G-MISS-HP 和 G-SVEST-R。统计分析包括 Pearson 项目间相关、可靠性分析、主轴因子分析和主成分分析（Promax 旋转）、验证性因子分析和 ROC 分析。
结果
共有 244 人做出了回应，其中 156 人完成了调查（33%的护士、16%的医生、9%的老年护士、7.1%的言语和语言治疗师）。项目间和校正项目-量表相关未能充分衡量一个项目。因此，该项目被排除在进一步分析之外。九项评分显示出良好的可靠性（Guttman 的 lambda 2 = 0.80；Cronbach 的 alpha = 0.79）。因子有效性得到了证明，表明与我们的两因素模型相比，原始研究中的三因素模型可能更好地代表数据。G-MISS-HP 和 G-SVESTR 子量表之间的正相关表明具有收敛效度。ROC 显示，使用 28.5 分的九项量表作为截断值，G-MISS-HP 的灵敏度为 89%，特异性为 63%。阳性和阴性预测值分别为 62%和 69%。亚组分析未发现任何差异。
结论
具有九项的 G-MISS-HP 是一种有效的、可靠的 MI 测试工具。然而，MI 和 SVP 的强烈相互关联表明需要进一步研究这些现象的区别。
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