Department of Nursing, Umeå University, Linnaeus v 9, 90736, Umeå, Sweden.
Department of Nursing, Umeå University, Campus Skellefteå, 93187, Skellefteå, Sweden.
BMC Med Ethics. 2023 May 30;24(1):35. doi: 10.1186/s12910-023-00916-x.
Moral distress has been described as moral constraints and uncertainty connected with guilty feelings of being unable to give care in accordance with one's values for good care. Various instruments to measure moral distress have been developed. The instrument measure of moral distress for healthcare professionals (MMD-HP) was developed to capture the experience and frequency of moral distress among various healthcare professionals. The MMD-HP has been translated and culturally adapted into the Swedish language and context; however, the translation has not been validated. Therefore, this study aimed to evaluate the validity and reliability of the Swedish version of the measure of moral distress for healthcare professionals (MMD-HP).
Eighty-nine staff from various professions at a hospital in northern Sweden participated in the study. A confirmatory factor analysis was performed to check for consistency with the original version of the MMD-HP. To evaluate internal consistency, Cronbach's alpha was calculated for each domain and for the scale as a whole.
The scale as a whole showed a Cronbach's alpha of 0.96, with a range between 0.84 and 0.90 between the different subscales. A confirmatory factor analysis based on the original four-factor structure showed good fit indices with a χ/df of 0.67, CFI at 1.00, TLI at 1.02 and NFI at 0.97. RMSEA was at 0.00, and SRMR was at 0.08. A comparison of the total score between three equally large groups of years of experience at the present workplace showed no significant differences (F = 0.09, df = 2, p = 0.912).
We found that the Swedish version of the MMD-HP has shown validity and reliability for use in a Swedish context for measuring moral distress among health personnel.
道德困境被描述为与无法按照自己的价值观提供良好护理而产生的内疚感有关的道德约束和不确定性。已经开发出各种衡量道德困境的工具。医疗保健专业人员道德困境衡量工具（MMD-HP）旨在捕捉各种医疗保健专业人员的道德困境体验和频率。MMD-HP 已被翻译成瑞典语并适应了瑞典的语言和文化环境；然而，该翻译尚未经过验证。因此，本研究旨在评估医疗保健专业人员道德困境衡量工具（MMD-HP）瑞典语版本的有效性和可靠性。
瑞典北部一家医院的 89 名来自不同职业的员工参加了这项研究。进行了验证性因素分析，以检查与 MMD-HP 原始版本的一致性。为了评估内部一致性，为每个域和整个量表计算了 Cronbach 的 alpha。
整个量表的 Cronbach's alpha 为 0.96，不同子量表之间的范围在 0.84 到 0.90 之间。基于原始四因素结构的验证性因素分析显示出良好的拟合指数，χ/df 为 0.67，CFI 为 1.00，TLI 为 1.02，NFI 为 0.97。RMSEA 为 0.00，SRMR 为 0.08。在 present workplace 工作年限相同的三个大组之间，总分比较没有显着差异（F=0.09，df=2，p=0.912）。
我们发现，MMD-HP 的瑞典语版本在瑞典语环境中具有有效性和可靠性，可用于衡量卫生人员的道德困境。
