Measure of Moral Distress for Healthcare Professionals--Japanese Version

Moral distress and moral sensitivity in clinical nurses

“…According to Silverman et al (2021), the Covid pandemic has led to the emergence of new sources of MD. In the present study, the situations in which MD was experienced the most were related to system root cause, consistent with the relevant literature (Asgari et al, 2019;Escolar-Chua, 2018;Fujii et al, 2021). The study findings showed that the item with the highest MD score was item 16, "Being required to care for more patients than I can safely care for," followed by "Having excessive documentation requirements that compromise patient care" and "Feeling required to overemphasize tasks and productivity or quality measures at the expense of patient care."…”

“…Comparable results were obtained in studies investigating the MD level among nurses, and the MD total score was observed to range from low to medium, with low-to-moderate frequency, and medium-to-high intensity (Borhaniet al, 2017;Epstein et al, 2019;Escolar-Chua, 2018;Fujii et al, 2021;Karagozoglu, et al, 2017;Oh & Gastmans, 2015;Prompahakul et al, 2021). This result of our study is thought to be related to the fact that the effects of the Covid pandemic were continuing during the period when the data were collected.…”

“…In the validity and reliability study T A B L E 2 EFA loads of the Turkish version of the MMD-HP. conducted by Fujii et al in Japan, the four-dimensional structure of the scale was found to be valid, and item 24 was loaded to a different dimension compared to the original scale (Fujii et al, 2021). In the present study, item 4 (Being unable to provide optimal care due to pressure from administrators or insurers to reduce costs), was loaded to the "Primarily Team-Level RC pressure" factor, unlike the original scale while item 25 (Working within power hierarchies in teams, units, and my institution that compromise patient care) and item 27 (Working with team members who do not treat vulnerable or stigmatized patients with dignity and respect) were loaded to "Primarily Team-Level RC Communication" as factor 4 although they were loaded to factor 3 in the original scale (Epstein et al, 2019).…”

“…The Kaiser-Meyer-Olkin test and Bartlett's sphericity test were used to assess the suitability of the data obtained from the sample for factor analysis. As there are significant cultural and political differences between the country in which the scale was developed and the country in which it was adapted and considering that there are differences with the original scale structure in the Japanese MMD-HP validity and reliability study conducted by Fujii et al (2021), an exploratory factor analysis (EFA) was conducted to assess the construct validity of the scale. In addition, confirmatory factor analysis (CFA) was used to compare the original structure with the structure obtained as a result of EFA.…”