Psychometric evaluation of a Spanish translation of the moral injury symptom scale for healthcare professionals

• Published in: BMC Psychology 2024-09, Vol.12 (1), p.468-10, Article 468
• Main Authors: Cabanillas-Chavez, María Teresa, White, Michael, Medina-Bacalla, Willy Jhon, Arévalo-Ipanaqué, Janet Mercedes, Zegarra, Roxana Obando, Suyo-Vega, Josefina Amanda, Morales-García, Mardel, Morales-García, Wilter C, Taylor, Elizabeth Johnston
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Burnout; Care and treatment; Confidentiality; COVID-19; Cross-Sectional Studies; Data collection; Diagnosis; Ethical aspects; Faith; Female; Health care; Health Personnel - psychology; Humans; Job satisfaction; Male; Medical care; Medical ethics; Medical personnel; Middle Aged; Moral injury; Morality; Morals; Nurses; Nurses - psychology; Nurses - statistics & numerical data; Nursing care; Pandemics; Participation; Patients; Peru; Post-traumatic stress disorder; Posttraumatic stress disorders; Professional ethics; Professionals; Psychological aspects; Psychometrics; Psychometrics - instrumentation; Quality management; Quantitative psychology; Questionnaires; Religion; Reproducibility of Results; Seminars; Social aspects; Spirituality; Statistical factor analysis; Surveys; Surveys and Questionnaires - standards; Translating and interpreting; Translations; Validity; Veterans
• ISSN: 2050-7283; 2050-7283
• DOI: 10.1186/s40359-024-01922-3

Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish. A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability. Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835. These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury.