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

Abstract

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.

Stress of conscience of COVID-19 among perianaesthesia nurses having worked in a COVID-ICU during the coronavirus pandemic: an international perspective

“…Further research on stress of conscience should be conducted. From the work of Jokwiro et al [ 36 ] we know that nurses were experiencing moral distress before the pandemic. The pandemic has further exacerbated that distress, resulting in nursing burnout and nurses leaving the profession.…”

Perceptions and Stress of Conscience in Relation to Burnout Among Nursing Staff in Older People Care Settings: A Quantitative Study

“…The SCQ index ranged from 0 to 25 points for each item. This questionnaire has been used in different countries (24,25,46). In the present study, Cronbach's α for the SCQ was estimated to be 0.82.…”

“…NS with higher levels of SC reported more health complaints than those with lower levels (23). Lack of time to provide necessary patient care and the in uence of workload on family life have been reported as familiar sources of SC among NS in Sweden, Finland, and Australia (8, [24][25][26]. Feeling obliged to provide insu cient care (9,24), lowering one's aspirations for providing good care, the inability to live up to others' expectations at work (24), and dealing with incompatible demands (24,26) are other prevalent sources of SC.…”

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

“…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 ]. Previous studies in healthcare settings found that this questionnaire is associated with health-related outcomes, such as burnout [ 27 ], and may be useful to early predict possible negative workplace outcomes [ 3 , 28 ]. However, as far as we know, the Italian version of this instrument is still lacking, and Italian healthcare organizations may be interested in having an instrument to evaluate their staff perceptions of moral distress during emergencies that can be used for both research and clinical purposes.…”