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Contenuto dell'articolo principale
Abstract
Scopo: Il Moral Distress (MD) è una sensazione dolorosa e/o squilibrio psicologico che può portare a conseguenze severe nel benessere lavorativo dell'infermiere. Gli infermieri che lavorano in psichiatria sperimentano molto probabilmente una tipologia diversa rispetto agli infermieri di altri reparti, di MD. Non esiste in Italia uno strumento per valutare il MD negli infermieri che lavorano in psichiatria. Lo scopo dello studio è di validare in lingua italiana la Moral Distress Scale for Psychiatric Nurses (MDS-P).
Metodo: per la traduzione è stata usato il metodo della forward e back-translation; è stata analizzata la validití di contenuto e di facciata della scala tradotta mediante un focus group con esperti del settore. Per verificare l'affidabilití è stato utilizzato il metodo del test-retest, attraverso la determinazione del coefficiente di correlazione di Spearman, del coefficiente di correlazione intraclasse (ICC) e dell'alfa di Cronbach.
Risultati: Il processo di forward e back-translation ha avuto successo. Dall'analisi del focus group, alla scala originale di 15 items sono stati aggiunti 8 items, derivati dai suggerimenti degli esperti. Alla fase del test retest hanno partecipato 32 infermieri. Il coefficiente di correlazione di Spearman è risultato essere 0,91, il Coefficiente di Correlazione Intraclasse > 0,9, l'alfa di Cronbach calcolata sul test, sul retest e su ogni singolo item sempre >0,9.
Conclusioni: La versione validata in lingua italiana della MDS-P risulta essere uno strumento valido, appropriato e affidabile per la misurazione del fenomeno del MD nella popolazione di infermieri che lavorano in ambito psichiatrico in Italia.
Parole Chiave: Moral Distress, Infermiere psichiatrico, Studi di validazione, Questionari, Etica.
Translation and validation in italian of the Moral Distress Scale for psychiatric nurses (MDS-P)
Abstract
Aim: Moral distress (MD) is a painful feeling and/or psychological disequilibrium, which may lead to negative consequences into the wellness of a nurse's working life. Nurses who work in psychiatry are more likely to experience a different type of MD compared with nurses of other contexts. In Italy a tool to evaluate MD in nurses who work in psychiatry doesn't exist. The aim of this study is to validate the Moral Distress Scale for Psychiatric Nurses (MDS-P) in Italian language. Method: For translation the forward and back-translation has been used; the effectiveness regarding content and face validity of the translated scale has been analyzed through a focus group with experts of the field. In order to check the reliability of the scale the test-retest method has been used, by means of the determination of Spearman's correlation coefficient, Intraclass Correlation Coefficient (ICC) and Cronbach's alpha. Results: The forward and back-translation process was successful. During the focus group analysis, 8 items were added to the 15 items of the original scale, due to experts suggestions. 32 nurses took part in the test-retest phase. Spearman's correlation coefficient resulted to be 0,91, ICC > 0,9, Cronbach's alpha calculated on test and retest, was always >0,9.
Conclusions: The Italian version of the MDS-P proves to be an effective, appropriate and reliable instrument to measure the MD phenomenon within the population of nurses who work in the psychiatric field in Italy.
Keywords: Moral Distress, Psychiatric Nursing, Validation Studies, Questionnaires, Ethics.
Dettagli dell'articolo
Riferimenti
- Austin, W., Bergum, V. & Goldberg, L. (2003). Unable to answer the call of our patients: mental health nurses' experience of moral distress. Nursing Inquiry, 10(3), 177-183.
- Beaton, D.E., Bombardier, C., Guillemin, F. & Bosi Ferraz, M. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.
- Corley, M.C., Elswick, R.K., Gorman, M. & Clor, T. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33(2), 250-256.
- Corley, M.C. (2002). Nurse moral distress: a proposed theory and research agenda. Nursing Ethics, 9(6), 636-650.
- Corley, M.C., Minick, P., Elswick, R.K. & Jacobs, M. (2005). Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), 381-390.
- Cunico, L. (2002) L'assistenza al paziente con problemi psichici. Milano: McGraw Hill, 41-63.
- Deady, R. (2010). A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspectives in Psychiatric Care, 46(3), 209-220. doi: 10.1111/j.1744-6163.2010.00260.x.
- Donner, A. & Eliasziw, M. (1987). Sample size requirements for reliability studies. Statistics in Medicine, 6, 441-448.
- Fain, J.A. (2004). La ricerca infermieristica leggerla, comprenderla e applicarla. Milano: McGraw-Hill, 137-157.
- Hamric, A.B. (2012). Empirical research on moral distress: issues, challenges, and opportunities. HEC Forum, 24, 39-49. doi: 10.1007/s10730-012-9177-x.
- Hamric, A.B., Borchers, C.T. & Epstein, E.G. (2012). Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research, 3(2), 1-9.
- Jameton, A. (1984). Nursing Practice: The Ethical Issues. Englewood Cliffs (NJ): Prentice-Hall.
- LoBiondo-Wood, G. & Haber, J. (2004). Metodologia della ricerca infermieristica. Milano: McGraw-Hill, 285-302.
- Magnusson, A & Lutzen, K. (1999). Intrusion into patient privacy: a moral concern in the home care of persons with chronic mental illness. Nursing Ethics, 6(5), 399-410.
- Negrisolo, A., & Brugnaro, L. (2012). Il moral distress nell'assistenza infermieristica. Professioni Infermieristiche, 65(3), 163-168.
- Ohnishi, K., Ohgushi, Y., Nakano M., Fujii H., Tanaka H., Kitaoka K., Nakahara J. & Narita Y. (2010). Moral distress experienced by psychiatric nurses in Japan. Nursing Ethics, 17(6), 726-740. doi: 10.1177/0969733010379178.
- Polit, D.F. & Beck, C.T. (2004). Nursing Research. Principles and Methods. Philadelphia: Lippicott Williams & Wilkins.
- Raucci, V. & Spaccapeli, G. (2013). Fondamenti di infermieristica in salute mentale. Santarcangelo di Romagna: Maggioli Editore, 20-37.
- Walter, S.D., Eliasziw, M. & Donner, A. (1998). Sample size and optimal design for reliability studies. Statistics in Medicine, 17 (1), 101-110.
Riferimenti
Austin, W., Bergum, V. & Goldberg, L. (2003). Unable to answer the call of our patients: mental health nurses' experience of moral distress. Nursing Inquiry, 10(3), 177-183.
Beaton, D.E., Bombardier, C., Guillemin, F. & Bosi Ferraz, M. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.
Corley, M.C., Elswick, R.K., Gorman, M. & Clor, T. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33(2), 250-256.
Corley, M.C. (2002). Nurse moral distress: a proposed theory and research agenda. Nursing Ethics, 9(6), 636-650.
Corley, M.C., Minick, P., Elswick, R.K. & Jacobs, M. (2005). Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), 381-390.
Cunico, L. (2002) L'assistenza al paziente con problemi psichici. Milano: McGraw Hill, 41-63.
Deady, R. (2010). A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspectives in Psychiatric Care, 46(3), 209-220. doi: 10.1111/j.1744-6163.2010.00260.x.
Donner, A. & Eliasziw, M. (1987). Sample size requirements for reliability studies. Statistics in Medicine, 6, 441-448.
Fain, J.A. (2004). La ricerca infermieristica leggerla, comprenderla e applicarla. Milano: McGraw-Hill, 137-157.
Hamric, A.B. (2012). Empirical research on moral distress: issues, challenges, and opportunities. HEC Forum, 24, 39-49. doi: 10.1007/s10730-012-9177-x.
Hamric, A.B., Borchers, C.T. & Epstein, E.G. (2012). Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research, 3(2), 1-9.
Jameton, A. (1984). Nursing Practice: The Ethical Issues. Englewood Cliffs (NJ): Prentice-Hall.
LoBiondo-Wood, G. & Haber, J. (2004). Metodologia della ricerca infermieristica. Milano: McGraw-Hill, 285-302.
Magnusson, A & Lutzen, K. (1999). Intrusion into patient privacy: a moral concern in the home care of persons with chronic mental illness. Nursing Ethics, 6(5), 399-410.
Negrisolo, A., & Brugnaro, L. (2012). Il moral distress nell'assistenza infermieristica. Professioni Infermieristiche, 65(3), 163-168.
Ohnishi, K., Ohgushi, Y., Nakano M., Fujii H., Tanaka H., Kitaoka K., Nakahara J. & Narita Y. (2010). Moral distress experienced by psychiatric nurses in Japan. Nursing Ethics, 17(6), 726-740. doi: 10.1177/0969733010379178.
Polit, D.F. & Beck, C.T. (2004). Nursing Research. Principles and Methods. Philadelphia: Lippicott Williams & Wilkins.
Raucci, V. & Spaccapeli, G. (2013). Fondamenti di infermieristica in salute mentale. Santarcangelo di Romagna: Maggioli Editore, 20-37.
Walter, S.D., Eliasziw, M. & Donner, A. (1998). Sample size and optimal design for reliability studies. Statistics in Medicine, 17 (1), 101-110.