Psychometric properties of the Turkish version of the Moral Injury Symptom Scale- Healthcare Professional

Abstract

Objectives: This study was carried out to examine the validity and reliability of a Turkish version of the Moral Injury Symptom Scale-Healthcare Professional (MISS-HP). Methods: This methodological study was performed with 125 nurses working in hospitals in Turkey in March-April 2021 using online forms. IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA) and IBM SPSS AMOS Version 21.0 software (IBM Corp., Armonk, NY, USA) were used to perform the analysis. Results: The linguistic validity of the MISS-HP was assessed using the translation-back translation technique and expert opinions. The sample size was found to be sufficient and suitable for factor analysis (Kaiser-Meyer-Olkin=0.888, chi-squared=1067.959, degrees of freedom [DF]=45, p=0.000). A 3-factor structure with 10 items was determined, and the factor load of the items ranged from 0.84 to 0.94. The fit index values were acceptable and within the limits of perfect agreement (minimum discrepancy/DF [CMIN/DF]=1.712, root mean square error of approximation [RMSEA]=0.076, standardized root mean squared residual [SRMR]=0.045, adjusted goodness-of-fit index [AGFI]=0.856, goodness-of-fit index [GFI]=0.916,Tucker-Lewis index [TLI]=0.970, relative fit index [RFI]=0.930, incremental fit index [IFI]=0.979, normed fit index [NFI]=0.950, comparative fit index [CFI]=0.978). Average variance extracted values >0.50 and composite reliability values >0.70 for each factor confirmed convergent and divergent validity of the scale.The Cronbach alpha reliability coefficient of the scale was 0.91 and the split-half reliability coefficient was 0.95. There was a statistically significant, moderate, positive correlation was seen between the Compassion Fatigue-Short Scale (CF-SS) and the MISS-HP scores (r=0.446, p=0.000). Conclusion: The Turkish version of the MISS-HP is a valid and reliable instrument to evaluate moral injury in healthcare professionals.