Moral resilience in registered nurses: Cultural adaption and validation study

Abstract

Background Healthcare professionals, especially professional nurses, experience various types of moral suffering due to inevitable ethical conflicts. Moral resilience is recently proposed as a resource to address moral suffering. However, there is no tool to measure moral resilience in Chinese professional nurses. Aim This study aimed to translate the Rushton Moral Resilience Scale (RMRS) into Chinese and evaluate the psychometric properties of the Chinese version of RMRS (Chi-RMRS). Research design A methodological and descriptive research design. Participants and research context A convenience sample of 411 Chinese professional nurses was recruited through an online survey platform between February and March 2023. Ethical considerations This study was approved by the Research Ethics Committees of the University and hospitals involved. Results The RMRS was translated and culturally adapted into a Chinese version. Neither floor nor ceiling effects were observed. The scale-level content validity index (CVI) was 0.922 with the item-level CVIs ranging from 0.833 to 1.000. The explanatory factor analysis (EFA) generated a three-factor structure for the Chi-RMRS, and the confirmatory factor analysis (CFA) demonstrated the three-factor structure with factor loadings for each item ranging from 0.42 to 0.80. The scale-level Cronbach’s α coefficient was 0.811 with each dimension ranging from 0.717 to 0.821, and composite reliability (CR) coefficient for the overall scale was 0.920, with each dimension varying from 0.739 to 0.824. The standard error of measurement (SEM) and smallest detectable change (SDC) were 3.522 and 9.763, respectively. Discussion The Chi-RMRS is able to measure moral resilience of Chinese professional nurses, and has good validity and reliability. It can be used in research and practice to determine the level of moral resilience, thus helping nursing managers to monitor the status of Chinese professional nurses, then develop interventions to maintain the well-being of professional nurses and to ensure quality of care.

Translation and validation of the revised “Rushton Moral Resilience Scale” in Greek

“…A similar study with nurses in Turkey was in accordance with the results of our con rmatory factor analysis (Kovanci & Atli Özbaş, 2023). Another study including nurses in China found a three-factors structure of the RMRS (Tian et al, 2023).…”

Mediating role of moral resilience and professional identity in the impact of nursing interns' moral distress on compassion fatigue: a cross-sectional study

“…The original version consists of 17 items categorized into 4 subscales: response to moral adversity, personal integrity, relational integrity, and moral e cacy [42]. Tian et al adapted the RMRS for the Chinese nurses, resulting in a 17-items version with 3 subscales: the ability to exibly cope with adversity (items 2, 4, 5, 6, and 8), relational moral soundness (items 10, 11, 13, 14, 15, and 16), and moral e cacy (items1, 3, 7, 9, 12, and 17) [43]. The Chinese version maintains satisfactory reliability, with a Cronbach's α of 0.811.…”