Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised*

Lamiani, Giulia; Setti, Ilaria; Barlascini, Luca; Vegni, Elena; Argentero, Piergiorgio

doi:10.1097/ccm.0000000000002187

Cited by 68 publications

(41 citation statements)

References 42 publications

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“…The Italian validated version of the Moral Distress Scale-Revised (MDS-R) (Hamric et al, 2012) was used to measure moral distress. The Italian MDS-R presented good reliability and psychometric properties (Lamiani et al, 2017b). The Italian MDS-R is composed of 14 items describing morally distressing situations.…”

Section: Moral Distressmentioning

confidence: 99%

Caring for Critically Ill Patients: Clinicians’ Empathy Promotes Job Satisfaction and Does Not Predict Moral Distress

et al. 2020

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Background: Several studies have highlighted the benefits of empathy in healthcare settings. A correlation between clinicians' empathy and patients' adherence and satisfaction, as well as the ability for the clinician to accurately assess family members' needs, has been found. However, empathy is often seen by clinicians as a risk factor for their wellbeing. This study aims to assess whether the level of empathy of clinicians working in critical care settings may expose them to moral distress, poor job satisfaction, and intention to quit their job. Methods: Italian clinicians who attended the 2016 "Smart Meeting Anesthesia Resuscitation in Intensive Care" completed the Empathy Quotient questionnaire, the Moral Distress Scale-Revised, and two questions assessing job satisfaction and intention to quit the job. Multiple linear and logistic regressions were performed to determine if clinicians' empathy influences moral distress, job satisfaction, and intention to quit. Age, gender, and profession were used as control variables. Results: Out of 927 questionnaires distributed, 216 were returned (23% response rate) and 210 were used in the analyses. Respondents were 56% physicians, 24% nurses, and 20% residents. Over half of the clinicians (58%) were female. Empathy resulted the only significant predictor of job satisfaction (β = 0.193; p < 0.05). None of the variables included in the model predicted moral distress. Conclusion: Empathy determined neither moral distress nor intention to quit. Findings suggest that empathy is not a risk factor for critical care clinicians in developing moral distress and the intention to quit their job. On the contrary, empathy was found to enhance clinicians' job satisfaction.

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Section: Moral Distressmentioning

confidence: 99%

Caring for Critically Ill Patients: Clinicians’ Empathy Promotes Job Satisfaction and Does Not Predict Moral Distress

et al. 2020

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“…The effect of MD needs more analysis so that researchers can make necessary changes and construct better moral healthcare environment 1 . The Moral Distress Scale‐Revised (MDS‐R) was used in this study because it is a commonly used valid and reliable instrument in the evaluation of MD among HCWs 32–34 …”

Section: Introductionmentioning

confidence: 99%

“…1 The Moral Distress Scale-Revised (MDS-R) was used in this study because it is a commonly used valid and reliable instrument in the evaluation of MD among HCWs. [32][33][34] On March 11, 2020, the World Health Organization declared Coronavirus COVID-19 a pandemic. 35 Such instant and unforeseen life-threatening event can lead to a huge level of psychologic pressure on HCWs, as previously reported during SARS or Ebola epidemics.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of moral distress among healthcare workers during COVID‐19 pandemic in Palestine

ALMasri

Rimawi

2022

Nursing Forum

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Background Moral distress among healthcare workers (HCWs) is considered a serious issue in all aspects of healthcare divisions, which needs an urgent intervention. Aims The study aims at evaluating moral distress among HCWs which will help the healthcare management and decision‐makers in hospitals and health centers to act in a comprehensiveness and effective way by reinforcing moral thinking and behavior in selected coronavirus (COVID‐19) quarantine centers across Palestine. Methods Ninety‐four HCWs were selected by convenience sampling method. Data were collected using revised Corley's Standard Moral Distress (MD) Scale and analyzed using SPSS software version 23. Results The mean score of MD for HCWs was low (1.24 ± 0.71). The mean score of MD severity was moderate (1.4 ± 0.93). The severity and frequency of MD in HCWs had a significant reverse relationship with years of experience, number of children of worker, and duration of work with COVID‐19 patients. Conclusion It is important to create a professional psychological support system for HCWs to decrease MD when facing moral issues.

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“…Nesse sentido, o distresse moral se manifesta na forma de sentimento de culpa por parte do profissional, causando impacto no processo de tomada de decisão moral e/ou clínica em situações moralmente complexas (Campbell et al, 2016;Fourie, 2015;Mccarthy & Deady, 2008). No entanto, os instrumentos validados e utilizados para mensuração do distresse moral, seja no Brasil ou no exterior, têm por base de construção o distresse relacionado ao constrangimento moral de Jameton, ignorando o distresse moral relacionado ao conflito ou incerteza moral (Barlem, Lunardi, Lunardi, Dalmolin, & Tomaschewski, 2012;Bernardi, Villagran, Lanes, Schutz, & Dalmolin, 2020;Corley, Elswick, Gorman, & Clor, 2001;Greco et al, 2020;Hamric, Borchers, & Epstein, 2012;Lamiani, Setti, Barlascini, Vegni, & Argentero, 2017;Ramos et al, 2017;Savel & Munro, 2015). Dessa forma, carece na literatura trabalhos que avaliem o distresse moral sob a perspectiva do conflito ou incerteza moral, principalmente no profissional médico.…”

Section: Introductionunclassified

Distresse moral de médicos relacionado à incerteza moral frente às diretivas antecipadas de vontade

Ribeiro

Swiech

Souza

et al. 2021

RSD

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Moral-uncertainty-distress (MUD) é o distresse moral relacionado ao conflito sobre qual melhor decisão em situações moralmente complexas. Propomos identificar a relação entre percepção do médico sobre as Diretivas Antecipadas de Vontade (DAV) e MUD, assim como o impacto na tomada de decisão. Neste estudo qualitativo, realizou-se entrevistas semiestruturadas com oito médicos de um hospital em Curitiba-PR tendo por base uma DAV verídica e, posteriormente, submetidas ao método de análise de conteúdo por categorização de Bardin. A primeira categoria identificada, DAV como elementos de conflito moral, revelou atitudes paternalistas por parte dos entrevistados, assim como insegurança por incertezas prognósticas, questionamento das DAV considerando motivações prévias do paciente e pouco conhecimento sobre as DAV. O reconhecimento das DAV como instrumentos de exercício da autonomia do paciente constituiu a segunda categoria encontrada. Apesar da identificação das DAV como ferramentas de autonomia, outros aspectos se mostraram moralmente desafiadores para os médicos entrevistados, sendo potencial fonte de MUD e impactando a tomada de decisão.

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Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised*

Cited by 68 publications

References 42 publications

Caring for Critically Ill Patients: Clinicians’ Empathy Promotes Job Satisfaction and Does Not Predict Moral Distress

Caring for Critically Ill Patients: Clinicians’ Empathy Promotes Job Satisfaction and Does Not Predict Moral Distress

An evaluation of moral distress among healthcare workers during COVID‐19 pandemic in Palestine

Distresse moral de médicos relacionado à incerteza moral frente às diretivas antecipadas de vontade

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