توسعه و اعتبارسنجي مقياس پريشاني اخلاقي در جامعه پرستاران ايران

Development and Validation of Scale Measuring: Moral Distress among Iranian Nurses

To develop a scale of measuring moral distress and validate it on a sample of Iranian registered nurses. Methods For the purpose of developing the Likert-type Questionnaire of moral distress introduced by Jameton in 1984, using Qualitative approaches 30 nurses completed and generated Jametoneʹs 30 statements reflecting clearly moral distress in their own language and perspectives. The scale had seven scoring points (1- Nil MD, 2, 3, 4,5,6 and 7-very high MD). We revised the items to ensure that all were clearly reflective in their form, as well as straightforward in their meaning, leaving 30 items in the raw scale, which was then applied to the convenience sample (rotal n=287) of female and male nurses. After the administration of the Questionnaire, we performed content examination, discriminated validation of the statements, and principal-components analysis by rotation varimax. Results After content and thematic analysis as well as discriminant validation of the statements and principal-components analysis, the final scale contained 30 items distributed in three subscales: "Ignorance of the pattern," "Patientʹs decision making power," and "Practical-professional competency." The Cronbach of the whole scale was ..., indicating good internal consistency. When the scores of the final scale were analyzed for the study sample, all participants showed a range of moral distress, with a mean score (±standard deviation) of ... out of maximum 7. The same was true for all three subscales. Conclusions It is possible to construct a reliable instrument to measure moral distress towards three important aspects of the ethicalrelated issues among the nurses:"Ignorance of the patient," "Patientʹs decision making power," and "Practical-professional competency. Future studies with this instrument, on different populations and in different cultural and socio-economic settings, are needed to make generalized conclusions on moral distress in the health care systems