Adaptation and Testing of a Military Version of the Measure of Moral Distress for Healthcare Professionals.

Autor:	Wilson MA; Melissa A. Wilson is a nurse scientist, US Air Force Research Laboratory, 711th Human Performance Wing, Wright-Patterson Air Force Base, Ohio., Simmons A; Angela Simmons is assistant dean for student affairs at the Uniformed Services University of the Health Sciences, Graduate School of Nursing, Bethesda, Maryland., Harris JI; J. Irene Harris is a clinician/ investigator, VA Maine Healthcare System, Lewiston, Maine., Thomas S; Sheila Thomas is an epidemiological statistician, Airmen Biosciences, Product Development, En Route Care, 711th Human Performance Wing, Wright-Patterson Air Force Base, Ohio., Shay A; Amy Shay is a clinical assistant professor, Indiana University, School of Nursing, Indianapolis., Usset TJ; Timothy J. Usset is executive director, Division of Health Policy and Management, University of Minnesota, Minneapolis., Cook W; Wendy Cook is associate director for professional education, the US Navy/Naval Medical Center San Diego, California., Bevington D; Daniel Bevington is a nurse educator at the Uniformed Services University of the Health Sciences, Bethesda, Maryland., Hurley AC; Ann C. Hurley is a senior nurse scientist, Brigham and Women's Hospital, Boston, Massachusetts., Epstein E; Elizabeth Epstein is an associate professor and associate dean of academic programs, University of Virginia School of Nursing, Charlottesville, Virginia.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2022 Sep 01; Vol. 31 (5), pp. 392-401.
DOI:	10.4037/ajcc2022177
Abstrakt:	Background: Moral distress is well-documented among civilian critical care nurses and adversely affects patient outcomes, care delivery, and retention of health care providers. Despite its recognized significance, few studies have addressed moral distress in military critical care nurses. Objectives: To refine and validate an instrument to assess moral distress in military critical care nurses. Methods: This study examined moral distress in military critical care nurses (N = 245) using a new instrument, the Measure of Moral Distress for Healthcare Professionals-Military (MMD-HP-M). The psychometric properties of the refined scale were assessed by use of descriptive statistics, tests of reliability and validity, exploratory factor analysis, correlations, and qualitative analysis of open-ended responses. Results: Initial testing showed promising evidence of instrument performance. The Cronbach α (0.94) suggested good internal consistency of the instrument for the overall sample. Scores for the MMD-HP items and the MMD-HP-M items showed a strong, significant correlation (α= 0.78, P < .001). Unique attributes of military nursing that contribute to moral distress included resource access, futile care, and austere conditions. Exploratory factor analysis established a new military-centric factor for question items associated with inadequate training for patient care, providing care in resource-limited settings, and personal exhaustion. Conclusions: These results will help guide specific, targeted interventions to reduce the negative effects of moral distress on our military health care providers, especially in terms of readiness for the next global pandemic and retention of these invaluable personnel. (©2022 American Association of Critical-Care Nurses.)
Databáze:	MEDLINE
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