ArticleFrontiers in psychology2026
Moral distress among healthcare professionals: Italian validation of the Moral Distress-Appraisal Scale.
Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Moral distress impacts healthcare professionals' well-being, yet current measurement tools often rely on specific clinical scenarios, limiting their applicability. This study aimed to validate the Italian version of the Moral Distress-Appraisal Scale (MD-APPS), a context-independent instrument to assess the subjective appraisal of moral distress. Materials and methods: A cross-sectional validation study was conducted. 205 professionals caring for patients with oncological and chronic-degenerative diseases across different settings were enrolled. The sample was randomly split to perform Exploratory and Confirmatory Factor Analyses. Results: Participants reported a mean MD-APPS total score of 1.85 (SD = 0.76) (scale range 1-6). The analysis supported a robust two-factor structure consistent with the original framework: Support and Freedom (Factor 1), Hindrance and Coercion (Factor 2). The scale demonstrated satisfactory model fit indices [ Discussion: The Italian MD-APPS appears a valid, reliable, and rapid-to-administer tool. By focusing on clinicians' appraisals of moral distress, the MD-APPS is consistent with emerging definitions of moral distress (i.e., perceived violations of professional values or norms). Although further research is warranted, the MD-APPS holds promise as a suitable tool for diverse healthcare contexts and professional sectors.
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