Development and Validation of a Moral Distress Scale for Nursing Students

Bordignon, Simoní Saraiva; Lunardi, Valéria Lerch; Barlem, Edison Luiz Devos; Dalmolin, Graziele de Lima; Silveira, Rosemary Silva da; Ramos, Flávia Regina Souza; Barlem, Jamila Tomaschewski

doi:10.1891/jnm-d-19-00001

Cited by 3 publications

(16 citation statements)

References 11 publications

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“…29 Nurses’ moral distress have been studied and measured fairly much, but moral courage as a mitigating factor to it has received fairly little attention. 30–32 A questionnaire to measure perioperative nurses’ moral courage has been developed, but the instrument has not been validated. 33,34…”

Section: Introductionmentioning

confidence: 99%

Nurses’ self-assessed moral courage and related socio-demographic factors

Hauhio

Leino‐Kilpi

Katajisto³

et al. 2021

Nurs Ethics

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Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses’ socio-demographic factors. Objective: To describe nurses’ self-assessed level of moral courage and its association with their socio-demographic factors. Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses’ Moral Courage Scale and analyzed statistically. Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses’ Moral Courage Scale in autumn 2017. Ethical considerations: Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process. Findings: Nurses’ self-assessed level of moral courage was rather high. On Visual Analogy Scale (0–10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses’ Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents’ gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses’ moral courage. Discussion: Strongest association was found between nurses’ higher moral courage level and formal and informal ethics education. Honesty and patient’s humane and dignified encounter received the highest scores indicating respondents’ internalization of the core values of nursing. Conclusion: Although nurses were fairly morally courageous, moral courage should be a part of nurses’ basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses’ moral courage.

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Section: Introductionmentioning

confidence: 99%

Nurses’ self-assessed moral courage and related socio-demographic factors

Hauhio

Leino‐Kilpi

Katajisto³

et al. 2021

Nurs Ethics

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show abstract

“…The aim of this study was to translate, culturally adapt and evaluate the psychometric properties of the ESMEE 42 based on a sample of Italian delayed nursing students. Overall, the results of this study suggest that the It-ESMEE is a valid and reliable instrument that can be used to measure moral distress in delayed nursing students, since nursing students are prone to moral distress, 7 with severe academic consequences, 18,19 and the measurement of moral distress is important for monitoring the levels they experience.…”

Section: Discussionmentioning

confidence: 99%

“…52 In the second step, consistent with recent developments, 53 the factorial validity of the It-ESMEE was examined prior to reliability testing. Since the It-ESMEE had been previously tested 42 using exploratory factorial analysis to evaluate its factorial validity for delayed nursing students, we used a confirmatory approach. Thus, we tested the factorial model applied to Brazilian nursing students 42 using CFA.…”

Section: Second Phase: Construct Validity Of the It-esmee Scalementioning

confidence: 99%

“…The forward and blind back-translations of the instrument revealed no discrepancies in the meaning of the items; however, six students asked for clarification of some items concerning specific examples of behaviour, the actors' ageing behaviour or experiences not included in the items. 42 Items 2,7,9,15,16,21,22,23,25,27,29,31,37,41,42,46,47,48,50 In the final step, the expert panel evaluated the instrument for semantic, cultural, linguistic and conceptual equivalence using the CVI, and we retained items with CVI �0.90 48 was item 1 (identify plagiarism by a student) (Table 3).…”

Section: Translation and Cultural Adaptation Of The Esmeementioning

confidence: 99%

“…Regular nursing students, as well as delayed students (those who cannot graduate in time because of failing exams or failing to progress from 1 year to the next), were included in their sample. The ESMEE demonstrated satisfactory internal consistency, but Bordignon et al's 42 exploratory factor analysis suggested using a confirmatory approach to test its factorial validity. To date, no previous study has tested the factorial validity of the ESMEE using confirmatory factor analysis (CFA), which is considered the best approach for testing such theoretically driven instruments.…”

Section: Introductionmentioning

confidence: 99%

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Moral distress in nursing students: Cultural adaptation and validation study

Mazzotta¹,

Bove²,

Badolamenti

et al. 2021

Nurs Ethics

Self Cite

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Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students. Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level). Research design: The study used a cross-sectional research design. Participants and research context: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy. Ethical considerations: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent. Results: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753–0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate. Discussion: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students. Conclusion: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

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Adaptation of Moral Distress Scale for Nursing Students into Turkish: A Validity and Reliability Study

Kovancı

Özbaş

2022

Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi

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Aim: Nursing students witness ethical and moral problems in health care settings and can even be involved in these situations. A student who wants to act for a solution with a sense of responsibility cannot take action due to his/her position and may feel powerless, inadequate, and helpless. This condition, defined as Moral Distress (MD), should be recognized, evaluated, and intervened by nurse educators to protect students' health, prevent weakness and provide qualified education. The study aims to introduce a valid and reliable measuring instrument to the Turkish Language and Culture that can be used to measure the MD levels of nursing students. Material and Methods: The sample of the study, which was carried out in methodological type, consisted of 410 3rd and 4th-grade nursing students studying at 48 different universities in 35 cities in Turkey. The data were collected online using the Participant Information form and Moral Distress Scale for Nursing Students (MDS-NS). Results: As a result of the explanatory factor analysis, different from the original scale structure, a three-factor structure that explains 47.64% of the total variance was determined. The reliability of the MDS-NS was evaluated with the Cronbach Alpha coefficient, test-retest method, and the item-total correlation coefficient. The Cronbach Alpha coefficient was .94 for the total scale and .85-.92 for the sub-dimensions. Conclusion: With its 41-item and three-factor structure, the MDS-NS is a valid and reliable tool for measuring the moral distress of nursing students. It is recommended to utilize MDS-NS in studies conducted to recognize, identify and measure MD, reduce MD and cope with MD.

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Development and Validation of a Moral Distress Scale for Nursing Students

Cited by 3 publications

References 11 publications

Nurses’ self-assessed moral courage and related socio-demographic factors

Nurses’ self-assessed moral courage and related socio-demographic factors

Moral distress in nursing students: Cultural adaptation and validation study

Adaptation of Moral Distress Scale for Nursing Students into Turkish: A Validity and Reliability Study

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