Stress of Conscience: Concept Clarification

Alkrisat, Muder; Alatrash, Manal

doi:10.18785/ojhe.1201.02

Cited by 9 publications

(5 citation statements)

References 12 publications

(18 reference statements)

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“…The term 'stress of conscience' has emerged to conceptualise an existential dimension of stress health professionals may develop from frequently encountered stressful situations in health care, perceived as leading to a troubled conscience [1][2][3][4]. Despite the heterogeneity of clinical settings, the generic sources of frequently encountered stressful situations across health care settings include perceived demanding workload, lack of support from leadership/management and staff conflict [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…In terms of reliability, the SCQ was found to be reliable (Cronbach’s α = 0.83) in a Swedish sample of hospital staff, as well as in samples of staff from municipal and community health care centres [ 2 , 3 , 16 ]. In terms of dimensionality, although the initial SCQ validation indicated two latent factors (Factor I = 1nternal Demands and Factor II = External Demands and Restrictions), there were high cross-loadings for Items 1, 3 and 8 on both factors [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia

et al. 2020

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Background This study explored the psychometric properties and dimensionality of the Stress of Conscience Questionnaire (SCQ) in a sample of health professionals from a tertiary-level Australian hospital. The SCQ, a measure of stress of conscience, is a recently developed nine-item instrument for assessing frequently encountered stressful situations in health care, and the degree to which they trouble the conscience of health professionals. This is relevant because stress of conscience has been associated with negative experiences such as job strain and/or burnout. The validity of SCQ has not been explored beyond Scandinavian contexts. Methods A cross-sectional study of 253 health professionals was undertaken in 2015. The analysis involved estimates of reliability, variability and dimensionality. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to explore dimensionality and theoretical model fit respectively. Results Cronbach’s alpha of 0.84 showed internal consistency reliability. All individual items of the SCQ (N = 9) met the cut-off criteria for item-total correlations (> 0.3) indicating acceptable homogeneity. Adequate variability was confirmed for most of the items, with some items indicating floor or ceiling effects. EFA retained a single latent factor with adequate factor loadings for a unidimensional structure. When the two‐factor model was compared to the one‐factor model, the latter achieved better goodness of fit supporting a one-factor model for the SCQ. Conclusion The SCQ, as a unidimensional measure of stress of conscience, achieved adequate reliability and variability in this study. Due to unidimensionality of the tool, summation of a total score can be a meaningful way forward to summarise and communicate results from future studies, enabling international comparisons. However, further exploration of the questionnaire in other cultures and clinical settings is recommended to explore the stability of the latent one-factor structure.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia

et al. 2020

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“…When people are prevented from doing good, they feel that they have not done what they ought to do, and this gives rise to a troubled conscience’’ [ 3 ] (p. 633). In this view, conscience is the “cornerstone of ethics” [ 23 ] because when a healthcare professional is aware of what “should be done” but he/she does not have the power or the resources to behave on this awareness, he/she will experience a troubled conscience as a result [ 23 , 24 , 25 ]. Then, in a broader and more practical sense, we can consider the concept of “moral distress” and “stress of conscience” as synonyms as they refer to a form of existential distress that impacts the conscience of professionals when they are prevented from following their own ethical and moral principles in the provision of care [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the construct of the stress of conscience has recently been cited when searching for measurements of the subjective experience of moral distress experience [ 26 ]. Indeed, feelings of a troubled conscience are the core manifestation of the phenomenon of moral distress [ 25 ]. In line with this, the Stress of Conscience Questionnaire [ 3 ] specifically developed to assess “stress of conscience” has been described as one of the existing instruments for assessing moral distress [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy

Maffoni

Fiabane

Setti

et al. 2022

IJERPH

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During the COVID-19 health emergency, healthcare professionals faced several ethical demanding job stressors, becoming at particular risk of moral distress. To date, only a few scales have been developed to evaluate moral distress among frontline professionals working in contact with COVID-19 patients. Moreover, although many healthcare professionals from various disciplines were converted to COVID-19 patient care, no study has yet analyzed whether the resulting change in duties might represent a risk factor for moral distress. Thus, this study aimed to investigate how and when the change in duties during the emergency would be related to healthcare professionals’ psycho-physical malaise. To this aim, a first Italian adaptation of the Stress of Conscience Questionnaire (SCQ) was provided. In total, 272 Italian healthcare professionals participated in this cross-sectional study. Healthcare professionals who had to perform tasks outside their usual clinical duties were more likely to experience moral distress and then psycho-physical malaise. This was particularly likely for those who were extremely concerned about becoming infected with the virus. The results also indicated that the Italian adaptation of the SCQ had a one-factor solution composed of six items. This study provides the first Italian adaptation of SCQ and practical suggestions on how supporting professionals’ well-being during emergencies.

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“…The conscience refers to an inner voice, a moral compass, or a set of integrated moral values guiding people on how to be or how to act (Glasberg et al, 2006; Rhodes, 2019), and it consists of a sense of accountability, including both responsibilities for past actions and obligations regarding future ones (Alkrisat & Alatrash, 2016; Cleary & Lees, 2019). According to Pellegrino (2002), healthcare professionals try to preserve their moral integrity by acting in line with their conscience.…”

Section: Introductionmentioning

confidence: 99%

Stress of conscience and burnout among nurses in Turkey

Yalçin

Yildirim

Kadıoğlu

et al. 2021

Perspect Psychiatric Care

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Purpose: To investigate the validity and reliability of the Turkish version of the Stress of Conscience Questionnaire (SCQ) and to determine its relationship to burnout among Turkish nurses. Design and Methods:The sample of this study with a cross-sectional design comprised 375 nurses. The data were collected using the Maslach Burnout Inventory (MBI) and SCQ. Findings:The mean score of the nurses obtained from the overall SCQ was 85.36 ± 39.3 (min: 0; max: 225). The highest scored item by the nurses was related to "lack of energy to devote themselves to their families." There was a significant positive correlation between the Emotional Exhaustion-MBI scores and SCQ scores (r = 0.414, p < 0.001).

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Stress of Conscience: Concept Clarification

Cited by 9 publications

References 12 publications

Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia

Stress of Conscience Questionnaire (SCQ): exploring dimensionality and psychometric properties at a tertiary hospital in Australia

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy

Stress of conscience and burnout among nurses in Turkey

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