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Abstract

Background: Moral distress (MD) has significant implications on individual and organizational health. However there is a lack of an instrument to assess it among Italian nurses. aim: The main aim of this study was to validate a brief instrument to assess MD, developed from the Corley's Moral Distress Scale (MDS).

Methods: The modified MDS scale was subjected to content and cultural validity. The scale was administered to 347 nurses. Psychometric analysis were performed to assess construct validity.

Results: The scale consists of 11 items, investigating MD in nursing practice in different clinical settings. The dimensionality of the scale was investigated through exploratory factor analysis (EFA), which showed a two-dimensional structure labeled futility and potential damage. The futility refers to feelings of powerlessness and ineffectiveness in some clinical situations; the potential damage dimension captures feelings of powerlessness when nurses are forced to tolerate or perform perceived abusive clinical proceedings. Nurses who experienced higher MD, were more lilely to experience burnout.

Conclusions: The modified MDS showed good psychometric properties, and it is valid and reliable for assessing moral distress among Italian nurses. Hence, the modified MDS allows to monitor the distress experienced by nurses and it is an important contribution to the scientific community and all those dealing with well-being of health workers.

Keywords: moral distress, professional burnout, medical futility, nursing ethics, clinical ethics


Scala sullo Stress Morale Modificata (MDS-11): Studio di Validazione tra gli Infermieri Italiani

Introduzione: Lo stress morale (DM) ha implicazioni significative sul benessere individuale e sull'organizzazione lavorativa. Tuttavia allo stato attuale non disponiamo di uno strumento per valutare il DM tra gli infermieri italiani. Obiettivo: Lo scopo principale del presente studio è stato quello di validare uno strumento sintetico per la valutazione del MD, sviluppato dalla Scala dello Stress Morale di Corley (MDS).

Metodo: La MDS modificata è stata sottoposta a validití  di contenuto e culturale. La scala è stata quindi somministrata a 347 infermieri. Si è eseguita l'analisi psicometrica per valutare la validití  di costrutto.

Risultati: La scala consta di 11 items che studiano il moral distress nell'assistenza infermieristica in diversi setting clinici. Le dimensioni della Scala sono state studiate con l'analisi fattoriale esplorativa (EFA), che ha evidenziato che essa consta di due dimensioni chiamate futilití  e danno potenziale. La futilití  si riferisce a sentimenti di impotenza e di inefficacia in alcune situazioni cliniche; a dimensione del danno potenziale cattura invece i sentimenti di impotenza quando si è costretti a tollerare o ad eseguire procedure cliniche ritenute abusive. Gli infermieri che maggiormente sperimentavano MD, erano più probabilmente esposti al burnout.

Conclusioni: La MDS modificata ha buone proprietí  psicometriche, ed è uno strumento valido e affidabile per la misurazione dello stress morale tra gli infermieri italiani. Quindi la MDS modificata permette di monitorare lo stress morale vissuto dagli infermieri, e fornisce un importante contributo alla comunití  scientifica e a tutti coloro che si occupano di benessere e salute dei lavoratori.

Parole chiave: stress morale, burnout, futilití  medica, etica infermieristica, etica clinica

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Badolamenti, S., Fida, R., Biagioli, V., Caruso, R., Zaghini, F., & Sili, A. (2018). Modified Moral Distress Scale (MDS-11): Validation Study Among Italian Nurses. PROFESSIONI INFERMIERISTICHE, 70(4). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/451
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