Moral distress thermometer: Translation and validation in Greek

Abstract

Background Moral distress occurs when people’s moral integrity is compromised by external factors. Healthcare workers experience difficult situations that can increase their moral distress. Aim To translate and validate the “Moral Distress Thermometer” (MDT) in Greek. Methods Our study included 142 nurses in Greece. We collected our data during September 2023. We employed the forward-backward method to translate and adapt the MDT in Greek. We examined the concurrent validity of the MDT using the “Moral Injury Symptom Scale-Healthcare Professionals” (MISS-HP), the revised “Rushton Moral Resilience Scale” (RMRS), the “Quiet Quitting Scale” (QQS), and the single item burnout measure. Moreover, we performed a test-retest study to examine the reliability of the MDT. Results The MDT showed very good psychometric properties. Concurrent validity of the Greek version of the MDT was exceptional. We found statistically significant correlations between the MDT and MISS-HP (r = 0.51, p < 0.001), RMRS (r = -0.33, p < 0.001), QQS (r = 0.41, p < 0.001), and the single item burnout measure (r = 0.40, p < 0.001). We found that the MDT had excellent reliability since the intraclass correlation coefficient in test-rest reliability analysis was 0.994 (95% confidence interval = 0.991 to 0.996, p-value < 0.001). Conclusions The “Moral Distress Thermometer” is a reliable and valid tool to measure moral distress among healthcare workers.