Hu Wei, Shang Ke, Wang Xin, Li Xia
First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning Province, China.
Jinzhou Medical University, Jinzhou, Liaoning, China.
BMC Nurs. 2024 Oct 3;23(1):711. doi: 10.1186/s12912-024-02380-3.
Quantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS).
In 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis-both Exploratory (EFA) and Confirmatory (CFA)-alongside assessments of internal consistency and test-retest reliability were employed.
Expert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS.
The Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China.
量化护士所面临的职业伦理挑战对于理论洞察和实际成果都至关重要。本研究的目的是评估《医疗保健专业人员道德困扰量表》（MD - APPS）中文版的心理测量特性。
2024年，采用调查方法与中国各地的几家三级医疗机构进行合作。因此，448名符合特定选择标准的护理专业人员被纳入研究。为评估该量表的信效度，采用了内容效度指数（CVI）、探索性因素分析（EFA）和验证性因素分析（CFA）以及内部一致性和重测信度评估等方法。
专家评估得出I - CVI为0.90，表明MD - APPS中文版具有良好的内容效度。探索性因素分析（EFA）揭示了一个由7个成分组成的二维框架，解释了累积方差的56.34%。验证性因素分析（CFA）结果显示χ²/df比率为1.542。稳健RMSEA估计值为0.054，SRMR确定为0.041。稳健TLI和稳健CFI指数均超过0.9阈值，表明拟合可接受；这一点得到了P值（卡方）0.094的支持。通过Cronbach's α测量的内部一致性为0.74，而两周期间的重测信度达到0.964。这些发现为中文版MD - APPS的心理测量特性提供了初步证据。
MD - APPS中文版显示出良好的初步心理测量特性，表明其在中国文化背景下探索护士职业伦理挑战方面具有潜在适用性。该量表可能有助于识别影响护士职业道德的各种因素，并评估护理实践中的伦理氛围。然而，需要进一步的验证研究来全面确立其在中国各种医疗环境中的心理测量稳健性。
