The Moral Distress Instrument (MDI): Development, Validation and Associations with Burnout among Finnish Social Workers

Abstract

ABSTRACT Moral distress (MD), the suffering experienced by professionals due to their restricted moral agency, has become a popular subject of study in the fields of social work and health care. Many of the existing measures of MD are targeted at certain professionals, such as health care workers, and are thus restricted to such contexts. This has challenged the conceptual development and empirical examination of MD as a phenomenon occurring across diverse professional groups in different work settings. This study introduces a general measure of MD, the Moral Distress Instrument (MDI). It is not bound to specific professional contexts, and it aims to enable comparative and cross-disciplinary analyses of MD. The MDI consists of seven items that capture different forms of constrained moral agency and follow-up items measuring the level of distress related to these experiences. The reliability and validity of the MDI is investigated, and its distinctiveness from and associations with burnout are studied among a sample of Finnish social workers (n = 367). The MDI was shown to be a reliable and valid measure among the sample. The measures of MD and burnout were shown to tap separate constructs, although these experiences were strongly associated with each other.