Cross-cultural adaptation of the moral distress scale for nursing and medicine students

Abstract

Introduction: Moral suffering is conceptualized as a psychological imbalance that affects individuals when they are faced with obstacles that make it impossible or difficult for them to intervene in reality and adopt attitudes and behaviors considered correct, in line with their moral judgment. Objective: To adapt the Moral Distress Scale for Nursing Students to the nursing and medical student population. Methods: This is a methodological study carried out in a federal public institution in southern Brazil with nursing and medical students. The study population was 900 students. The adaptation of the scale followed the stages of an expert committee, pre-test, sending the final version for approval by the original author and evaluation of the psychometric properties of the adapted instrument. For analysis, Cronbach’s Alpha, exploratory and confirmatory factor analysis and Machine Learning algorithm were used, through Linear Discriminant Analysis. Ethical precepts were met in accordance with Resolution 466/2012, and the study was approved by opinion nº: 1,888,749 of the Research Ethics Committee of the federal institution. Results: 459 students participated in the study, 342 from the medical course and 117 from the nursing course. The Portuguese version of the instrument presented Cronbach’s alpha of 0.98 and the confirmatory analysis demonstrated the suitability of the model with four components and 36 validated items. Using the Machine Learning Linear Discriminant Analysis method, the instrument was analyzed for non-parametric data using the median and interquartile range and parametric data using the mean and standard deviation, presenting the same results. Conclusion: The Moral Distress Scale for Nursing Students is valid and reliable for analyzing moral distress in nursing and medical students.