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. 2017 Sep 4;4(4):251–266. doi: 10.1002/nop2.91

Table 2.

Frequency and level of disturbance of the items of the Moral Distress Scale version 1a

Frequency Level of disturbance
n b Proportion of answers over scale (n, %) Mean SDc n b Proportion of answers over scale (n, %) Mean SDc
0 (= never) 1 2 3 4 (= very often) 0 (= none) 1 2 3 4 (= very high)
Professional ethical principles

  1. I consciously rely on professional ethical principles when making decisions regarding patient care.

 2109 10 (0.5%) 54 (2.6%) 225 (10.7%) 974 (46.2%) 846 (40.1%) 3.23 .78 ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐
Moral distress
  • 1

    Provide less than optimal care due to pressure from administrators or insurers to reduce costs.

 2143 170 (7.9%) 598 (27.9%) 685 (32.0%) 552 (25.8%) 138 (6.4%) 1.95 1.05 2115 115 (5.4%) 269 (12.7%) 551 (26.1%) 782 (37.0%) 398 (18.8%) 2.51 1.10
  • 2

    Witness healthcare providers giving “false hope” to a patient or family.

 2130 425 (20.0%) 776 (36.4%) 547 (25.7%) 308 (14.5%) 74 (3.5%) 1.45 1.07 2100 283 (13.5%) 406 (19.3%) 525 (25.0%) 629 (30.0%) 257 (12.2%) 2.08 1.23
  • 3

    Carry out the physician's orders for what I consider to be unnecessary tests and treatments.

 2136 98 (4.6%) 586 (27.4%) 714 (33.4%) 527 (24.7%) 211 (9.9%) 2.08 1.05 2111 146 (6.9%) 519 (24.6%) 676 (32.0%) 549 (26.0%) 221 (10.5%) 2.08 1.09
  • 4

    Avoid taking action when I learn that a physician or nurse colleague has made a medical error and not reported it.

 2103 1134 (53.9%) 619 (29.4%) 230 (10.9%) 89 (4.2%) 31 (1.5%) .70 .93 2087 446 (21.4%) 314 (15.0%) 414 (19.8%) 471 (22.6%) 442 (21.2%) 2.07 1.44
  • 5

    Be required to care for patients I don't feel qualified to care for.

 2136 1094 (51.2%) 826 (38.7%) 157 (7.4%) 43 (2.0%) 16 (0.7%) .62 .77 2113 725 (34.3%) 361 (17.1%) 269 (12.7%) 388 (18.4%) 370 (17.5%) 1.68 1.52
  • 6

    Work with nurses or other healthcare providers who are not as competent as patient care requires.

 2122 416 (19.6%) 910 (42.9%) 480 (22.6%) 260 (12.3%) 56 (2.6%) 1.35 1.01 2095 311 (14.8%) 423 (20.2%) 451 (21.5%) 579 (27.6%) 331 (15.8%) 2.09 1.30
  • 7

    Ignore situations of suspected patient abuse by caregivers.

 2090 1501 (71.8%) 394 (18.9%) 119 (5.7%) 47 (2.2%) 29 (1.4%) .43 .81 2088 653 (31.3%) 221 (10.6%) 288 (13.8%) 396 (19.0%) 530 (25.4%) 1.97 1.60
  • 8

    Watch patient care suffer because of a lack of provider continuity.

 2125 191 (9.0%) 645 (30.4%) 649 (30.5%) 447 (21.0%) 193 (9.1%) 1.91 1.11 2104 182 (8.7%) 418 (19.9%) 614 (29.2%) 621 (29.5%) 269 (12.8) 2.18 1.15
  • 9

    Work with levels of nurse or other care provider staffing that I consider unsafe.

 2134 359 (16.8%) 583 (27.3%) 480 (22.5%) 406 (19.0%) 306 (14.3%) 1.87 1.30 2107 253 (12.0%) 327 (15.5%) 446 (21.2%) 565 (26.8%) 516 (24.5%) 2.36 1.32
a

German items were translated for this publication

b

Deviations from the overall total of 2153 resulted from participants' freedom to answer individual items

c

SD: Standard deviation