Development of Thai Moral Integrity Scale in Professional Nurses

Authors

  • Jinda Nunthawong RN, PhD Candidate, Faculty of Nursing, Chulalongkorn University, Thailand.
  • Jintana Yunibhand RN, PhD, Dip.APPMHN, Associate Professor, Faculty of Nursing, Chulalongkorn University, Thailand.
  • Waraporn Chaiyawat RN, PhD, DNS , Dip. APPN, Associate Professor, Faculty of Nursing, Chulalongkorn University, Thailand.

Keywords:

Scale development, Moral integrity, Thai professional nurses

Abstract

                  Moral integrity is fundamental to morality that represents the ability of nurses to face a moral/ethical situation and provide direction for nursing practice. Moral integrity assessment is necessary for nurses. In Thailand the Code of Professional Conduct and Registered Nurses Competence in Ethics is a guideline for moral integrity and ethical standard. The aim of this study was to develop the Thai Moral Integrity Scale and to test its psychometric properties. The construct definition and content domains of this instrument were developed through intensive literature reviews and testing of its content validity by five experts.

                 The Moral Integrity Scale consists of 27 items with a Likert-type scale. The result of testing with 502 professional nurses by using exploratory factor analysis indicated that there were four dimensions that can explain the moral integrity in professional nurses that consists of: (1) express intention to follow the Thai Code, (2) adhere to and follow the Thai Code, (3) continue to follow the Thai Code, and (4) show courage to act according to the Thai Code’s tenets. All these dimensions can explain 55.98% of the total variance. The construct validity was tested by using confirmatory factor analysis when tested with professional nurses. The results indicated that the measurement model had good fit with the data. The Cronbach’s alpha coefficient reliability of the total scale was .92.

                  The results indicated acceptable validity and reliability of the final version of the Thai Moral Integrity Scale that provides an alternative way to assess moral integrity in Thai professional nurses, especially for new graduates to assess their moral integrity in nursing practice representing highest levels of quality of care.

References

1. Elmore J, Wright DK, Paradis M. Nurses’ moral experiences of assisted death: A meta-synthesis of
qualitative research. Nurs Ethics. 2018; 25(8):955-72.

2. Safavi F, Ebrahimi H, Areshtonab HN, Khodadadi E, Fooladi M. Relationship between demographic
characteristics and ethical reasoning of nurses working in medical wards. J Clin Diagn Res. 2018;12(8):1-4.

3. Milliken A, Grace P. Nurse ethical awareness: Understanding the nature of everyday practice. Nurs Ethics. 2017;24(5):517-24.

4. Avci K, Cinaroglu S, Top M. Perception of pediatric nurses on ethical decision making processes. Syst Pract Act Res. 2017;30(1):67-84.

5. Rest J. Revised manual for the defining issues test. Minneapolis: MN: Minnesota Moral Reserach Project; 1979.

6. Olson L. The relationship between moral integrity, psychological well-being, and anxiety. Charis: the Institute of Wiscosin Lutheran College. 2002;2(1):21-8.

7. Lind G. The theory of moral cognitive devlopment: a socio-psychological assessment. Trans Wren. In Moral development and the social environment.Chicago: Precendent; 1985.

8. Alba B. Factors that impact on emergency nurses’ ethical decision-making ability. Nurs Ethics. 2018; 25(7):855-66.

9. Carter S. integrity. New York: Basic Books, a division of Herper Collins Publishers; 1996.

10. Arpananthikul M, Prapaipanich W, Senadisai S. Nursing administrators perception ot Thai register nurses’professional ethics. Thai J NursCouncil, . 2014;29(2):5-20.

11. Jormsri P, Kunaviktikul W, Ketefian S, Chaowalit A. Moral competence in nursing practice. Nurs Ethics. 2005;12(6):582-94.

12. Thailand Nursing & Midwifery Council. The professional nurses practiced base on Nursing and Midwifery Regulation on Code of Professional Conduct (B.E.2550).

13. Susan M. Oncology nurses’ narratives about ethical dilemmas and prognosis related communication in advanced cancer patients. Cancer Nurs. 2013;36(2):114-21.

14. Pavlish C, Brown-Saltzman K, Hersh M, Shirk M, Rounkle A-M. A Nursing priorities, actions, and regrets for ethical practice. J Nurs Scholarsh. 2011;43:385-95.

15. Barlow N, Hargreaves J, Gillibrand W. Nurses’ Contributions to the Resolution of Ethical Dilemmas in Practice. Nurs Ethics. 2018; 25(2):230-42.

16. Epstein E, Delgado S. Understanding and addressing moral distress. Online J Issues Nurs. 2010;15(3).

17. Jahromi MK, Koshkaki AR, Poorgholami F, Talebizadeh M. A Study of Nurses’ Perception of Professional Values in the University Hospitals Affiliated with Jahrom University of Medical Sciences, 2015. Bangladesh Med J. 2018;17(1):47-51.

18. Fourie C. Moral distress and moral conflict in clinical ethics. Bioethics. 2015;29(2):91-7.

19. LaSala CA, Bjarnason D. Creating workplace environments that support moral courage. Online J Issues Nurs. 2010;15(3).

20. Eriksen A. The authority of professional roles. J Soc Philos. 2015;46(3):373-91.

21. Laabs C. Perceptions of moral integrity: contradictions in need of explanation. Nurs Ethics. 2011;18(3):431-40.
22. Wicclair M. Conscientious Objection in Healthcare and Moral Integrity. Camb Q Health Ethics. 2017;26(1):7-17.

23. Association AN. Code of ethics for nurses with interpretive statement. Silver Spring. 2015;MD Author.

24. Kohlberg L. The philosophy of moral development: Moral stages and the idea of justice: San Francisco: Harper & Row; 1931.

25. Parker RS. Measuring nurses’ moral judgments. J Nurs Scholarsh. 1990;22(4):213-8.

26. DeVellis R. Scale development. 2nd, editor. Newbury Park: CA: Sage; 2012.

27. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research: Springer Publishing Company; 2010.

28. Crocker L, Algina J. introduction to classical and modern test theory New York: Cengage Learning; 2008.

29. Nunnally J, Bernstein I. Psychometric Theory 3rd edition (MacGraw-Hill, New York). 1994.

30. Soper D. SEM sample size calculator 2017 [Available from: https://www.DANIELSOPER.Com/statcalc3/calc.aspx?id=89.

31. Burns N, Grove, S. K. . Understanding nursing research. 5th, editor. Maryland Heights: MO:Elesevier/Saunders; 2011.

32. Polit DF, Beck, CT., Owen, SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendation. Res Nurs Health. 2007;30(4):459-67.

33. Schumacker RE, Lomax RG. A beginner’s quide to structural equation modeling. 2nd edn. Mahwah, New Jersey: Lawrence Erlbaum Associates; 2011.

34. Tabachnick BG, Fidell LS. Using multivariate statistics, 6th edn Boston. Ma: Pearson. 2013.

35. Hair J, Black B, Babin B, Anderson R. Multivariate Data Analysis 7th Pearson Prentice Hall. Upper Saddle River,NJ. 2010.

36. Sadooghiasl A, Parvizy S, Ebadi A. Concept analysis of moral courage in nursing: A hybrid model. Nurs Ethics. 2018;25(1):6-19.

37. Kidder RM, McLeod B. Moral courage: W. Morrow New York; 2005.

38. Lachman VD. Moral courage: a virtue in need of development. Medsurg Nurs. 2007;16(2):131.

39. Comrey AL, Lee HB. A first course in factor analysis: Psychology press; 2013.

40. Walker LO, Avan KC. Strategies for theory construction in nursing . 4th , editor. New Jersey: Pearson Education; 2005

Downloads

Published

2020-01-02

How to Cite

1.
Nunthawong J, Yunibhand J, Chaiyawat W. Development of Thai Moral Integrity Scale in Professional Nurses. PRIJNR [Internet]. 2020 Jan. 2 [cited 2024 Dec. 19];24(1):102-17. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/178635

Issue

Vol. 24 No. 1 (2020): January-March 2020

Section

Original paper

License

Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.