Psychometric evaluation of the moral distress risk scale: a methodological study

Rafaela Schaefer*, Elma L. C. P. Zoboli, Margarida M. Vieira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. Objective: To psychometrically test the Moral Distress Risk Scale. Research design: A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants and research context: In total, 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. Findings: The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach’s α = 0.913, a total variance explained of 59%, a Kaiser–Meyer–Olkin = 0.896, and a significant Bartlett <0.001. Discussion: Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Conclusion: Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts.
Original languageEnglish
Pages (from-to)434-442
Number of pages9
JournalNursing Ethics
Issue number2
Publication statusPublished - 1 Mar 2019


  • Ethics
  • Factor analysis
  • Instrument development
  • Moral distress
  • Nursing
  • Statistical
  • Validation studies


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