Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.
Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.
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DOI：
10.1080/23294515.2019.1586008
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发表时间：
2019-04-01
影响因子：
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通讯作者：
Hamric, Ann B
中科院分区：
文献类型：
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作者：
Epstein, Elizabeth G;Whitehead, Phyllis B;Hamric, Ann B
背景技术背景：由于正在进行的研究探讨道德困扰对医疗保健专业人员（HCP）和组织的影响，并寻求制定有效的干预措施，有效和可靠的工具来衡量道德困扰是必要的。本文介绍了广泛使用的道德困扰量表修订版（MDS-R）的发展和测试，以衡量道德困扰。我们修订了MDS-R，评估了22项先前研究的综合数据，评估了301个写入项目和209个通过道德困扰咨询确定的根本原因，并回顾了各专业最近发表的14篇文章，其中描述了根本原因。修订后的27项量表，即医疗保健专业人员道德困扰测量（MMD-HP），可供成人和儿科危重、急性或长期急性护理环境中的所有HCP使用。然后，我们评估了MMD-HP的信度和通过假设检验评估结构效度。MMD-HP，医院伦理气候调查（HECS），和人口统计调查通过Qualtrics电子分发给护士，医生，和其他医疗保健专业人员在两个学术医疗中心在3周periods.RESULTS：在总数中，653调查被纳入最终分析。MMD-HP显示出良好的可靠性。（1）护士的MMD-HP评分（M112.3，SD73.2）高于医生（M96.3，SD54.7，p=0.023）; (2)考虑离职者的MMD-HP评分（M 168.4，SD 75.8）高于不考虑离职者（M 94.3，SD 61.2，p
BACKGROUND: As ongoing research explores the impact of moral distress on health care professionals (HCPs) and organizations and seeks to develop effective interventions, valid and reliable instruments to measure moral distress are needed. This article describes the development and testing of a revision of the widely used Moral Distress Scale-Revised (MDS-R) to measure moral distress.METHODS: We revised the MDS-R by evaluating the combined data from 22 previous studies, assessing 301 write-in items and 209 root causes identified through moral distress consultation, and reviewing 14 recent publications from various professions in which root causes were described. The revised 27-item scale, the Measure of Moral Distress for Healthcare Professionals (MMD-HP), is usable by all HCPs in adult and pediatric critical, acute, or long-term acute care settings. We then assessed the reliability of the MMD-HP and evaluated construct validity via hypothesis testing. The MMD-HP, Hospital Ethical Climate Survey (HECS), and a demographic survey were distributed electronically via Qualtrics to nurses, physicians, and other health care professionals at two academic medical centers over a 3-week period.RESULTS: In total, 653 surveys were included in the final analysis. The MMD-HP demonstrated good reliability. The four hypotheses were supported: (1) MMD-HP scores were higher for nurses (M 112.3, SD 73.2) than for physicians (M 96.3, SD 54.7, p=0.023). (2) MMD-HP scores were higher for those considering leaving their position (M 168.4, SD 75.8) than for those not considering leaving (M 94.3, SD 61.2, p