• Olu Awosoga, Em M Pijl, Brad Hagen, Barry Hall, Tolulope Sajobi, and Shannon Spenceley.
• Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
• J Adv Nurs. 2018 Nov 1; 74 (11): 2685-2700.

AimsTo report on the development and validation of the Moral Distress in Dementia Care Survey instrument.BackgroundDespite growing awareness of moral distress among nurses, little is known about the moral distress experiences of nursing staff in dementia care settings. To address this gap, our research team developed a tool for measuring the frequency, severity and effects of moral distress in nursing staff working in dementia care.DesignThe research team employed an exploratory sequential mixed method design to generate items for the moral distress questionnaire. Data were collected between January 2013 - June 2014. In this paper, we report on the development and validation of the Moral Distress in Dementia Care Survey instrument.MethodsThe Moral Distress in Dementia Care Survey instrument was piloted with a portion of the target population prior to a broader implementation. Appropriate statistical analyses and psychometric testing were completed.ResultsThe team collected 389 completed surveys from registered nurses, licensed practical nurses and healthcare aides, representing a 43.6% response rate across 23 sites. The Moral Distress in Dementia Care Survey emerged as a reliable and valid instrument to measure the frequency, severity and effects of moral distress for nursing staff in dementia care settings. The relative value of the Moral Distress in Dementia Care Survey as a measurement instrument was superseded by its clinical relevance for dementia care staff.ConclusionThe Moral Distress in Dementia Care Survey is a potentially useful tool for estimating the frequency, severity and effects of moral distress in nursing staff working in dementia care settings and for the evaluation of measures taken to mitigate moral distress.© 2018 John Wiley & Sons Ltd.

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