The Graduate Center, City University of New York, New York, NY, USA.
Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, USA.
Nurs Ethics. 2023 Sep;30(6):789-802. doi: 10.1177/09697330231151349. Epub 2023 Mar 28.
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.
To describe the modification and psychometric evaluation of the Moral Distress Questionnaire.
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.
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.
The study was approved by the university's human research protection program. Informed consent was provided to all participants.
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.
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.
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.
在长期护理机构工作的注册护士如果不能解决伦理挑战，可能会导致道德困境。目前缺乏一种经过英语验证的工具来充分衡量长期护理环境中的道德困境。
描述道德困境问卷的修改和心理测量评估。
仪器开发和心理测量评估。使用 SPSS 版本 27.0 进行内部一致性，即 Cronbach's α 以建立可靠性，而 SPSS Amos 版本 27.0 用于进行道德困境问卷的验证性因素分析。
通过 Facebook 采用靶向抽样方法，从 2020 年 12 月 7 日至 2021 年 3 月 7 日招募了在美国长期护理机构提供直接居民护理的美国注册护士的全国样本。
该研究得到了大学人类研究保护计划的批准。向所有参与者提供了知情同意。
共有 215 名参与者完成了调查。验证性分析表明，道德困境问卷模型的 21 项 4 因素结构量表符合既定标准，表现出可接受的模型拟合度（CMIN/DF=2.0，CFI=0.82，TLI=0.77，RMSEA=0.07）。每个项目的因子负荷与给定的基础结构呈中度至高度相关（范围 0.36-0.70）。总体量表的 Cronbach's α 系数为 0.87，其分量表的 Cronbach's α 系数为 0.60-0.74，表明具有良好的可靠性。
这是第一个充分衡量美国长期护理护士在长期护理环境中经历的道德困境的经过英语验证的工具。这种可靠且经过良好验证的工具将有助于识别美国长期护理护士经历的道德困境情况。
经过修改的 21 项英文版道德困境问卷是一种可靠的工具，具有良好的心理测量特性，可有效衡量直接居民护理护士的道德困境来源。
