Construção Da Escala Brasileira De Distresse Moral Em Enfermeiros - Um Estudo Metodológico

Abstract

Objective: to develop an instrument called the Brazilian Scale of Moral Distress in Nurses, in order to measure the intensity and frequency of moral distress.Method: a methodological research described in three steps: 1) definition of the theoretical framework (Background); 2) Instrument design; and 3) instrument composition.Step 2 integrated the literature review and survey to identify elements / situations triggering moral distress. The sample consisted of 771 nurses, from the 27 states of Brazil, working in different services.Results: moral distress situations analyzed by the survey were analyzed in five rounds involving a group of researchers, producing an analytical matrix with nine categories and 72 subcategories, which subsidized the formulation of the initial questions, and improved and collated with the findings of the literature (validation of criterion). Three other rounds were performed for the composition of the instrument, with 57 questions and a double Likert scale, with successive revisions of the content, language, format and layout, including the evaluation by experts / judges and analysis of the results of the pre-test (face/content). Conclusion: explore specific conditions of the Brazilian context of nurses' work and the validation of the instrument produced will allow the understanding of the theme of moral suffering in the Brazilian nursing scenario. Constructing instruments capable of measuring expressions of moral distress can validate ethical problems already described with adapted instruments. DESCRIPTORS: Nursing research. Moral. Suffering. Scales. Validation studies. CONSTRUÇÃO DA ESCALA BRASILEIRA DE DISTRESSE MORAL EM ENFERMEIROS -UM ESTUDO METODOLÓGICO RESUMOObjetivo: desenvolver um instrumento denominado Escala Brasileira de Distresse Moral em enfermeiros, para medição da intensidade e frequência do distresse moral.Método: pesquisa metodológica descrita em três etapas: 1) definição do marco teórico (background); 2) concepção do instrumento; e 3) composição do instrumento. A etapa 2 integrou a revisão da literatura e survey para identificar elementos/situações desencadeadoras de distresse moral. A amostra consistiu de 771 enfermeiros, dos 27 estados do Brasil, atuantes em diferentes serviços.Resultados: foram analisadas situações de distresse moral apreendidas pelo survey, em cinco rodadas envolvendo grupo de pesquisadores, produzindo uma matriz analítica com nove categorias e 72 subcategorias, que subsidiaram a formulação das questões iniciais, aprimoradas e cotejadas com os achados da literatura (validação de critério). Outras três rodadas foram realizadas para composição do instrumento, com 57 questões e dupla escala Likert, em sucessivas revisões do conteúdo, linguagem, formato e layout, incluindo a avaliação por experts/ juízes e análise dos resultados do pré-teste (validação de face/conteúdo).Conclusão: explorar condições específicas do contexto brasileiro do trabalho de enfermeiros e a validação do instrumento produzido permitirá compreender o tema do sofrimento mora...

Necesidades De Docentes Y Estudiantes Para Humanizar La Formacion De Enfermería

“…Esto puede provocar sufrimiento moral (moral distres) en los profesionales de salud y generar dificultades para tener un actuar moralmente pertinente a una situación determinada, pudiendo conducir a burnout. Para mitigarlo, la formación ética y los procesos deliberativos son relevantes (23) . Cuando profesoras de enfermería reconocen que una formación humanizada puede favorecer cuidados humanizados, coinciden con el actuar de buenas formadoras de enfermería, quienes demuestran ser espejo entre el cuidado con sus pacientes y estudiantes, formándolos para modelar en ellos un cuidado humanizado (24) .…”

Intensity and frequency of moral distress in Brazilian nurses

“…The instrument applied was the EDME-Br, developed and validated in the Brazilian context (15) . This is a six-point Likert scale that evaluates the frequency and intensity of moral distress, where 0 = never/none, 6 = very frequent/very intense, and 3 is the mean value.…”

“…The six MD assessment factors measured by the EDME-Br are "Acknowledgement, power and professional identity" (eleven items), "Safe and qualified care" (eleven items), "Defense of values and rights" (eight items), "Work conditions" (six items), "Ethical infractions" (six items) and "Work teams" (seven items) (15) . For data analysis, the program PASW Statistic ® (Predictive Analytics Software, SPSS Inc., Chicago, USA) version 22.0 for Windows was used.…”

“…In view of ruptures and conceptual continuities, MD was analyzed from the reflection on spaces of power and resistance and patients advocacy, and also related to the ethical, political and advocacy inexpressiveness of professionals (14) . This theoretical framework formed the basis of the present study and of the development of the Brazilian Moral Distress Scale in Nurses (Portuguese acronym: EDME-Br) (15) .…”

Generating situations of Moral Distress in Primary Care Nurses

“…In Brazil, MD studies have been developed with some variations of approaches, such as bibliographic reviews, methodological studies, reflection, validation, quantitative research and qualitative research (3,(5)(6)(7)(8)(9)(10) . Thus, it is evident the importance of understanding the process of MD in the different contexts of the nurse's performance.…”