gms | German Medical Science

Background and Purpose: Nurses may experience moral distress because of workplace constraints. Due to its possible adverse effects, it is advisable to continuously monitor moral distress. In 2010 no suitable instrument existed within the German-speaking context. Hence the purpose of this study was to develop and psychometrically test such an instrument.

Methods: This study was performed within a mixed methods research design with two cycles of data collection by all registered nurses in five Swiss hospitals. After translation and preliminary adaption of an American version of a moral distress scale (MDS), we prior pilot tested the questionnaire. The first data collection in 2011 consisted of a cross-sectional survey by the electronic questionnaire, followed by focus group interviews and a subsequent integration of the results, using an integration matrix. In 2015 we administered the refined questionnaire by the same way as we did in 2011. Quantitative data were analyzed using descriptive statistics and Rasch analysis, qualitative data were analyzed by knowledge maps.

Results: The results of the first survey showed that moral distress is also a salient phenomenon in Swiss hospitals. The result of the integration gave important hints for the refinement of the questionnaire. The Rasch analysis of the second dataset showed that the questionnaire is reliabel.

Conclusions: A Rasch-scaled German speaking MDS is now available for use in future monitoring. Our results showed the importance of a continuous monitoring, also in our nursing context.

Disclosure of Interest:

Michael Kleinknecht-Dolf reports no conflict of interests.

Marianne Müller reports no conflict of interests.

Jacqueline Martin reports no conflict of interests.

Rebecca Spirig reports no conflict of interests.

Funding Information: This research was funded in part by the Swiss National Science Foundation (CRSII3_132786/1), the Käthe-Zingg-Schwichtenberg Fond, the Gottfried und Julia Bangerter-Rhyner-Stiftung, the Olga Mayenfisch Stiftung, the Swiss Nurses Association, the Stiftung Pflegewissenschaft Schweiz, and by another Foundation, which does not want to be mentioned with its name.