Validation of the German Version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) and Its Correlation to the Second Victim Phenomenon

Milena Trifunovic-Koenig, Reinhard Strametz, Bianka Gerber, Sneha Mantri and Stefan Bushuven
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Milena Trifunovic-Koenig: Institute for Infection Control and Infection Prevention, Health Care Association District of Constance, 78315 Konstanz, Germany
Reinhard Strametz: Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
Bianka Gerber: Institute for Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau Bodensee Hospital Singen, 78224 Singen, Germany
Sneha Mantri: Department of Neurology and Trent Center for Bioethics, Humanities, and History of Medicine, Duke, University School of Medicine, Durham, NC 27710, USA
Stefan Bushuven: Institute for Infection Control and Infection Prevention, Health Care Association District of Constance, 78315 Konstanz, Germany

IJERPH, 2022, vol. 19, issue 8, 1-19

Abstract: Introduction: Comparable to second victim phenomenon (SVP), moral injury (MI) affects health professionals (HP) working in stressful environments. Information on how MI and SVP intercorrelate and their part in a psychological trauma complex is limited. We tested and validated a German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) instrument, screening for MI and correlated it with the recently developed German version of the Second Victim Experience and Support Tool (G-SVESTR) instrument, testing for SVP. Methods: After translating Moral Injury Symptom and Support Scale for Health Professionals (MISS-HP), we conducted a cross-sectional online survey providing G-MISS-HP and G-SVEST-R to HP. Statistics included Pearson’s interitem correlation, reliability analysis, principal axis factoring and principal components analysis with Promax rotation, confirmatory factor and ROC analyses. Results: A total of 244 persons responded, of whom 156 completed the survey (33% nurses, 16% physicians, 9% geriatric nurses, 7.1% speech and language therapists). Interitem and corrected item-scale correlations did not measure for one item sufficiently. It was, therefore, excluded from further analyses. The nine-item score revealed good reliability (Guttman’s lambda 2 = 0.80; Cronbach’s alpha = 0.79). Factor validity was demonstrated, indicating that a three-factor model from the original study might better represent the data compared with our two-factor model. Positive correlations between G-MISS-HP and G-SVESTR subscales demonstrated convergent validity. ROC revealed sensitivity of 89% and specificity of 63% for G-MISS-HP using a nine-item scale with cutoff value of 28.5 points. Positive and negative predictive values were 62% and 69%, respectively. Subgroup analyses did not reveal any differences. Conclusion: G-MISS-HP with nine items is a valid and reliable testing instrument for moral injury. However, strong intercorrelations of MI and SVP indicate the need for further research on the distinction of these phenomena.

Keywords: moral injury; moral conflict; moral distress; moral stress; moral tension; moral constraint; second victim; medical error; health professionals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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