Translation and validation for Persian version of Abbreviated Moral Injury Outcome Scale (AMIOS) in emergency health professionals: a comprehensive methodological approach.

BACKGROUND

Emergency health professionals face health risks and ethical dilemmas that can impact their well-being. This study evaluates the psychometric properties of the Persian version of the Abbreviated Moral Injury Outcome Scale (AMIOS) for these professionals.

METHODS

This scale development study was carried out in Mashhad, Iran, in 2024. The original AMIOS was translated using a forward-backward method. Content validity was assessed using the Content Validity Ratio (CVR) and Content Validity Index (CVI), based on assessments from 11 experts. Face validity was evaluated both quantitatively through the impact score and qualitatively. Construct validity was analyzed with Confirmatory Factor Analysis involving 280 participants. Reliability was measured by Cronbach's alpha and McDonald's omega coefficients for internal consistency and Intraclass Correlation Coefficient (ICC) for stability, based on data from 30 emergency health professionals.

RESULTS

The translated questionnaire demonstrated confirmed face validity. The content validity indices were acceptable with a CVR of 0.802 and a CVI of 0.762. Construct validity was supported, with item factor loadings exceeding 0.4. The internal consistency was strong: Cronbach's alpha was 0.837 for Shame-related Outcomes, 0.788 for Trust Violation Outcomes, and an overall alpha of 0.881. The ICC was 0.859, indicating good reproducibility.

CONCLUSIONS

The Persian version of AMIOS is a valid and reliable instrument for assessing the impact of moral injury in emergency healthcare settings. This tool facilitates a more comprehensive understanding and diagnosis of moral injuries.