ORIGINAL RESEARCH article
Front. Psychol.
Sec. Quantitative Psychology and Measurement
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1661414
Psychometric Development of a Moral Distress Scale for Healthcare Education and Practice
Provisionally accepted
- Chung Shan Medical University, Taichung, Taiwan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Unaddressed moral distress may result in psychological, emotional, and physical consequences. The study was to develop and validate a Moral Distress Scale for Healthcare Students and Providers (MDS-HSP) within the Taiwanese healthcare education and clinical contexts, providing a framework for administrators and policymakers to recognize and respond to moral distress in training and practice settings. Methods: Following an extensive literature review and expert discussions, the study performed an exploratory factor analysis (EFA) using SPSS with a sample of 332 participants to determine the hidden structure of the MDS-HSP and evaluate its initial psychometric properties. A subsequent confirmatory factor analysis (CFA) using AMOS with a separate sample of 240 participants was performed to verify the identified factor structure. The testing process included the assessments of validity, reliability, and goodness-of-fit analysis. Results: Following the EFA, the initial 72 items were refined to 42 items across six factors: "acquiescence to patients' rights violations" (8 items), "lack of professional competence" (9 items), "disrespect for patients' autonomy" (10 items), "futile treatment" (5 items), "organizational and social climate" (6 items), and "not in patients' best interest" (4 items). The CFA confirmed the same six scale factors and 42 items. Both EFA and CFA supported the proposed factor structure and demonstrated adequate validity and reliability. Conclusion: The study provided empirical evidence supporting the MDS-HSP as a reliable tool for assessing moral distress experienced by healthcare students and providers. Its use may inform educational strategies, institutional policies, and ethical support mechanisms within healthcare and academic settings.
Keywords: Moral distress, scale development, Healthcare education, Psychometric validation, factor analysis
Received: 07 Jul 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Liao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ya-Huei Wang, Chung Shan Medical University, Taichung, Taiwan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.