TY - JOUR

T1 - Re-assessing the validity of the Moral Sensitivity Questionnaire (MSQ)

T2 - Two new scales for moral deliberation and paternalism

AU - Kuilman, Luppo

AU - Jansen, Gerard J.

AU - Mulder, Laetitia B.

AU - Middel, Berrie

AU - Roodbol, Petrie F.

N1 - © 2020 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

PY - 2020/1/23

Y1 - 2020/1/23

N2 - RATIONALE, AIMS, AND OBJECTIVES: The current study and previous research have called the six-component model of Lützen's 30-item Moral Sensitivity Questionnaire (MSQ) into question. For this reason, we re-examined the construct validity of this instrument.METHODS: In this cross-sectional study, which was based on a convenience sample of Dutch nurse practitioners (NPs) and physician assistants (PAs), we tested the validity of MSQ items using exploratory and confirmatory factor analyses (EFA and CFA, respectively).RESULTS: The EFA revealed a two-component model, which was then tested as a target model with CFA and was found to have good model fit. Some items were correlated with two uncorrelated latent constructs, which we labelled as "paternalistic" and "deliberate" attitudes towards patients.CONCLUSIONS: As in previous studies, the analyses in the current study, which was conducted among PAs and NPs, did not reveal six dimensions for the 30 items. Two new latent dimensions of moral sensitivity were psychometrically tested and confirmed. These two components relate to studies investigating ethical behaviour, and they can be used to describe the moral climate in healthcare organizations. The scales are indicators of the extent to which health professionals behave in a deliberate (sensitive) or paternalistic (insensitive) manner towards the opinions of patients within the context of medical decision-making.

AB - RATIONALE, AIMS, AND OBJECTIVES: The current study and previous research have called the six-component model of Lützen's 30-item Moral Sensitivity Questionnaire (MSQ) into question. For this reason, we re-examined the construct validity of this instrument.METHODS: In this cross-sectional study, which was based on a convenience sample of Dutch nurse practitioners (NPs) and physician assistants (PAs), we tested the validity of MSQ items using exploratory and confirmatory factor analyses (EFA and CFA, respectively).RESULTS: The EFA revealed a two-component model, which was then tested as a target model with CFA and was found to have good model fit. Some items were correlated with two uncorrelated latent constructs, which we labelled as "paternalistic" and "deliberate" attitudes towards patients.CONCLUSIONS: As in previous studies, the analyses in the current study, which was conducted among PAs and NPs, did not reveal six dimensions for the 30 items. Two new latent dimensions of moral sensitivity were psychometrically tested and confirmed. These two components relate to studies investigating ethical behaviour, and they can be used to describe the moral climate in healthcare organizations. The scales are indicators of the extent to which health professionals behave in a deliberate (sensitive) or paternalistic (insensitive) manner towards the opinions of patients within the context of medical decision-making.

KW - deliberation

KW - moral sensitivity

KW - nurse practitioner

KW - paternalism

KW - physician assistant

KW - EXPLORATORY FACTOR-ANALYSIS

KW - PATIENT AUTONOMY

KW - CARE

KW - NURSES

KW - MODEL

KW - QUALITY

KW - POWER

U2 - 10.1111/jep.13353

DO - 10.1111/jep.13353

M3 - Article

C2 - 31975512

VL - 26

SP - 659

EP - 669

JO - Journal of Evaluation in Clinical Practice

JF - Journal of Evaluation in Clinical Practice

SN - 1356-1294

IS - 2

ER -