Construction of the Brazilian scale of moral distress in nurses - a methodological study

Abstract

Objective: to develop an instrument called the Brazilian Scale of Moral Distress in Nurses, in order to measure the intensity and frequency of moral distress. Method: a methodological research described in three steps: 1) definition of the theoretical framework (Background); 2) Instrument design; and 3) instrument composition. Step 2 integrated the literature review and survey to identify elements / situations triggering moral distress. The sample consisted of 771 nurses, from the 27 states of Brazil, working in different services. Results: moral distress situations analyzed by the survey were analyzed in five rounds involving a group of researchers, producing an analytical matrix with nine categories and 72 subcategories, which subsidized the formulation of the initial questions, and improved and collated with the findings of the literature (validation of criterion). Three other rounds were performed for the composition of the instrument, with 57 questions and a double Likert scale, with successive revisions of the content, language, format and layout, including the evaluation by experts / judges and analysis of the results of the pre-test (face/content). Conclusion: explore specific conditions of the Brazilian context of nurses’ work and the validation of the instrument produced will allow the understanding of the theme of moral suffering in the Brazilian nursing scenario. Constructing instruments capable of measuring expressions of moral distress can validate ethical problems already described with adapted instruments.