Validity and reliability study of the Moral Distress Questionnaire in Turkish for nurses

Understanding factors influencing healthcare workers' intention towards the COVID-19 vaccine

Globally, healthcare workers (HCWs) are at high risk of acquiring Coronavirus infection. In addition, they are role models for the general public concerning attitudes towards the COVID-19 vaccine. In addition, they play a critical role in successfully promoting practices aiming to reduce the transmission of COVID-19 infection. Therefore, this study broadly based on the theory of planned behavior (TPB) explores the factors influencing HCWs' intention to be vaccinated. An online survey was administered using Google Form to collect data from HCWs working in the public health sector of Pakistan. The sample included 813 participants, two-thirds were female, and one-third were male. In addition, 41.5% of them were aged between 26-35 years, 32.6% had master's level education, 25% were nurses, and 57.7% of them were living in urban areas. Data analysis was run using Partial Least Squares Structural Equation Modeling (PLS-SEM). The research findings reveal the positive and significant effect of the TPB factors (attitude, subjective norms, and perceived behavioral control) and the extended factor of vaccine confidence on HCWs' intention to be vaccinated. This study's model explains 66.4% of variations in HCWs' intention to be vaccinated.

Structure internal of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure

OBJECTIVE

to analyze the evidence of validity of the internal structure of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure.

METHOD

psychometric study with 1,008 people with heart failure, in a tertiary healthcare institution located in Northeastern Brazil. The internal structure was assessed by exploratory factor analysis with a polychoric correlation matrix, followed by confirmatory factor analysis to verify the quality of the model fit. Internal consistency was measured by composite reliability (CR) and McDonald's omega (ω).

RESULTS

psychometric parameters revealed 22-item model, distributed in five factors, total explained variance of 64.9%, factor loadings (0.38 to 0.97) and adequate communalities (0.20 ≤ h2 ≤ 0.98) and acceptable indicators of precision (0.79 ≤ ORION ≤ 0.98), representativeness (0.89 ≤ FDI ≤ 0.99), sensitivity (1.92 ≤ SR ≤ 7.07), factor expectancy (88.3% ≤ EPTD ≤ 97.9%), replicability (0.82 ≤ H-latent ≤ 0.97; 0.81 ≤ H-observed ≤ 0.87) and reliability (CR = 0.92 and ω = 0.83). Adequate adjustment quality was achieved (TLI = 0.99; CFI = 0.99; GFI = 0.99; RMSEA = 0.04 and RMSR = 0.04).

CONCLUSION

We obtained an instrument with good evidence of internal structure validity for construct measurement.

Translation and Validation of Nursing Students' Knowledge and Attitudes of Lesbian, Gay, Bisexual, Transgender Health Concerns Survey in the Greek Language

Nursing students have limited knowledge of providing quality care to lesbian, gay, bisexual, and transgender individuals. The aim of this study was to explore the psychometric properties of the Nursing Students’ Knowledge of and Attitudes toward Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Concerns (NKALH) survey as well as to examine whether sociodemographic variables may affect attitudes toward LGBT individuals. In this cross-sectional study which was carried out from January−March 2022, 258 nursing students from two Greek universities completed the NKALH. For survey translation, the procedure of forward and backward translation was followed. Construct validity, reliability, and internal consistency were explored via confirmatory factor analysis, the test−retest reliability method, and Cronbach’s alpha index. The correlation between the dimensions of the attitude subscale was used to explore convergent validity. Analyses were carried out with the Statistical Package for the Social Sciences (SPSS), version 26.0. The level of significance was set at <0.05. Confirmatory factor analysis confirmed that the attitude subscale consists of three dimensions (Comfortable, Responsibility, Willingness to Care). The Pearson test (r) revealed strong correlations between two measurements (Comfortable r = 0.932, p < 0.001, Responsibility r = 0.938, p < 0.001, and Willingness to Care r = 0.915, p < 0.001), indicating good reliability. The Cronbach’s alpha index of the total scale was 0.783, highlighting its good internal consistency. Bivariate analysis revealed that sexual orientation, religion, and age are related to knowledge and attitudes toward LGBT individuals. The NKALH survey is a valid and reliable tool to measure the knowledge and attitudes of Greek nursing students on the health concerns of LGBT individuals.

Validation of a Spanish Adaption of a Questionnaire for Measuring Nomophobia among University Students

Smartphones are highly useful in contemporary society. However, their use can lead to problems, such as dependency and addiction. Nomophobia is a pathological fear of losing connectedness or not being able to access information or communicate with other people. The objectives of this study were to evaluate the four dimensions of the original version of the NMP-Q questionnaire by Yildirim and Correia using the Spanish version of the questionnaire developed by Gutiérrez-Puertas et al. Similarly, this research aims at assessing whether the questionnaire retains its four-dimensional structure when applied to a population of university students in the area of social sciences at a Mexican university. Using confirmatory and exploratory factor analysis techniques, we determined that nomophobia among the study population can be addressed through the first three dimensions of the original questionnaire, namely, not being able to communicate, losing connectedness, and not being able to access information. A fourth dimension, entitled “giving up convenience”, is mentioned in the literature. However, in this study, this dimension could not be clearly identified with the indicators included in the original questionnaire and was, therefore, omitted from the resulting questionnaire. Nomophobia is a modern phenomenon that is becoming increasingly prevalent in our society. Therefore, it must be studied and addressed. The nomophobia questionnaire presented in this article is a reliable way of taking measurements, as indicated by the research results. Further research should deepen the study of measuring nomophobia and improve the questionnaire through other indicators and conceptual dimensions that help explain this phenomenon in a precise and reliable way.

Moral Distress in Healthcare Providers Who Take Care of Critical Pediatric Patients throughout Italy-Cultural Adaptation and Validation of the Italian Pediatric Instrument

Background: Although Moral Distress (MD) is a matter of concern within the Pediatric Intensive Care Unit (PICU), there is no validated Italian instrument for measuring the phenomenon in nurses and physicians who care for pediatric patients in Intensive Care. The authors of the Italian Moral Distress Scale-Revised (Italian MDS-R), validated for the adult setting, in 2017, invited further research to evaluate the generalizability of the scale to clinicians working in other fields. Our study aims to reduce this knowledge gap by developing and validating the pediatric version of the Italian MDS-R. Methods: We evaluated the new instrument for construct validity, then we administered it in a multicenter, web-based survey that involved healthcare providers of three PICUs and three adult ICUs admitting children in northern, central, and southern Italy. Finally, we tested it for internal consistency, confirmatory factorial validity, convergent validity, and differences between groups analysis. Results: The 14-item, three-factor model best fit the data. The scale showed good reliability (a = 0.87). Still, it did not correlate with the Emotional Exhaustion and Depersonalization sub-scales of the Maslach Burnout Inventory (MBI) or with the 2-item Connor-Davidson Resilience Scale (CD-RISC 2) or the Satisfaction with Life Scale (SWLS). A mild correlation was found between the Italian Pediatric MDS-R score and intention to resign from the job. No correlation was found between MD and years of experience. Females, nurses, and clinicians who cared for COVID-19 patients had a higher MD score. Conclusions: The Italian Pediatric MDS-R is a valid and reliable instrument for measuring MD among Italian health workers who care for critically ill children. Further research would be helpful in better investigating its applicability to the heterogeneous scenario of Italian Pediatric Critical Care Medicine.

Instruments for Detecting Moral Distress in Clinical Nurses: A Systematic Review

Moral distress (MD) has become a seriously negative problem experienced by healthcare professionals, especially clinical nurses. Early and accurate detection of MD by the validated and reliable instrument is critically important to further develop an effective intervention strategy. We performed the current systematic review to comprehensively summarize the evidence of instruments for the detection of MD in clinical nurses. The research design was a systematic literature review. We assigned 2 investigators to independently search potential studies in PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) from their inception to June 2020. We used data extraction table extracting essential information, and the modified critical appraisal tool evaluating the reliability and validity of eligible instruments. Finally, we qualitatively summarized results of all included instruments. No ethical approval was required because this systematic review was performed based on published studies. We included 16 eligible studies covering 10 original and 6 revised or modified instruments for the final analysis. The overall quality of all instruments was moderate because test-retest reliability was inadequately examined in most instruments. Of 16 instruments, MDS-revised (MDS-R) was broadly validated and employed in different working or cultural settings. Meanwhile, it also extensively expands to specifically detect MD. Moreover, other instruments including moral distress risk scale (MDSR) and moral distress thermometer (MDT) should be further validated and utilized because it covered the gap missed by most instruments. Although several instruments have been made available for clinical nurses, some of them have inadequate psychometric properties test, especially test-retest reliability evaluation. Meanwhile, most of them have not be validated and employed in other working or cultural settings. We therefore suggested further studies to validate the psychometric properties of existing instruments and then employed instruments with high reliability and validity to detect MD in clinical nurses.