title: Measuring moral distress in pharmacy and clinical practice.
abstract: This article presents the development, validation and application of an instrument to measure everyday moral distress in different health care settings. The concept of moral distress has been discussed and developed over 20 years. A few instruments have been developed to measure it, predominantly in nursing. The instrument presented here consists of two factors: level of moral distress, and tolerance/openness towards moral dilemmas. It was tested in four medical departments and three pharmacies, where 259 staff members completed a questionnaire. The two factors were found to be reliable. Differences in levels of moral distress were found between pharmacies and clinical departments, and between the youngest and oldest age groups; departmental staff and the youngest group experienced higher levels of moral distress. Departments reported less tolerance/openness towards moral dilemmas than pharmacies. The instrument needs to be tested further, but its strengths are the focus on everyday ethical dilemmas and its usefulness in different health care settings.
authors.affiliation: Uppsala University, Uppsala, Sweden. sofia.kalvemark@pubcare.uu.se
authors.forename: Sofia Kälvemark
authors.initials: SK
authors.lastname: Sporrong
authors.forename: Anna T
authors.initials: AT
authors.lastname: Höglund
authors.forename: Bengt
authors.initials: B
authors.lastname: Arnetz
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D003220:Conflict, Psychological; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009014:Morals; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000941:ethics / Q000523:psychology; D010594:Pharmacies; D010595:Pharmacists / Q000941:ethics / Q000523:psychology; D010820:Physicians / Q000941:ethics / Q000523:psychology; D011340:Problem Solving / Q000941:ethics; D036301:Qualitative Research; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden