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Nursing Ethics
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Measuring Moral Distress in Pharmacy and Clinical Practice

Sofia Kälvemark Sporrong

Uppsala University, Uppsala, Sweden, sofia.kalvemark{at}pubcare.uu.se

Anna T Höglund

Uppsala University, Uppsala, Sweden

Bengt Arnetz

Uppsala University, Uppsala, Sweden, and Wayne State University, Detroit, MI, USA

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.

Key Words: clinical practice • ethics • moral distress • pharmacy practice • scale development

Nursing Ethics, Vol. 13, No. 4, 416-427 (2006)
DOI: 10.1191/0969733006ne880oa
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