Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4898
Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Advancement of the German version of the moral distress scale for acute care nurses : a mixed methods study
Authors : Kleinknecht-Dolf, Michael
Spichiger, Elisabeth
Müller, Marianne
Bartholomeyczik, Sabine
Spirig, Rebecca
DOI : 10.21256/zhaw-4898
10.1002/nop2.91
Published in : Nursing Open
Volume(Issue) : 4
Issue : 4
Pages : 251
Pages to: 266
Issue Date: 2017
Publisher / Ed. Institution : Wiley
ISSN: 2054-1058
Language : English
Subjects : Ethics; Hospital; Instrument development; Mixed methods design; Monitoring; Moral distress; Nurses; Nursing; Psychometrics; Questionnaire
Subject (DDC) : 610.73: Nursing
Abstract: Aim: Moral distress experienced by nurses in acute care hospitals can adversely impact the affected nurses, their patients and their hospitals; therefore, it is advisable for organizations to establish internal monitoring of moral distress. However, until now, no suitable questionnaire has been available for use in German‐speaking contexts. Hence, the aim of this study was to develop and psychometrically test a German‐language version of the Moral Distress Scale. Design: We chose a sequential explanatory mixed methods design, followed by a second quantitative cross‐sectional survey. Methods: An American moral distress scale was chosen, translated, culturally adapted, tested in a pilot study and subsequently used in 2011 to conduct an initial web‐based quantitative cross‐sectional survey of nurses in all inpatient units at five hospitals in Switzerland's German‐speaking region. Data were analysed descriptively and via a Rasch analysis. In 2012, four focus group interviews were conducted with 26 nurses and then evaluated using knowledge maps. The results were used to improve the questionnaire. In 2015, using the revised German‐language instrument, a second survey and Rasch analysis were conducted. Results: The descriptive results of the first survey's participants (n = 2153; response rate: 44%) indicated that moral distress is a salient phenomenon in Switzerland. The data from the focus group interviews and the Rasch analysis produced information valuable for the questionnaire's further development. Alongside the data from the second survey's participants (n = 1965; response rate: 40%), the Rasch analysis confirmed the elimination of previous deficiencies on its psychometrics. A Rasch‐scaled German version of the Moral Distress Scale is now available for use.
URI: https://digitalcollection.zhaw.ch/handle/11475/13285
Fulltext version : Published version
License (according to publishing contract) : CC BY 4.0: Attribution 4.0 International
Departement: School of Engineering
Organisational Unit: Institute of Data Analysis and Process Design (IDP)
Appears in Collections:Publikationen School of Engineering

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