Volume 28, Issue 4 (3-2026)
jha 2026, 28(4): 43-56 |
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Shojaeimotlagh V, Habibpour Z, Sodeify R, Ghanei Gheshlagh R. Psychometric evaluation of the Persian version of the moral injury symptoms scale–health professional among Iranian nurses. jha 2026; 28 (4) :43-56
URL: http://jha.iums.ac.ir/article-1-4733-en.html
URL: http://jha.iums.ac.ir/article-1-4733-en.html
1- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
2- Determinants of Nursing, Khoy University of Medical Sciences, Khoy, Iran.
3- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. & Nursing Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey. ,rezaghanei30@gmail.com
2- Determinants of Nursing, Khoy University of Medical Sciences, Khoy, Iran.
3- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. & Nursing Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey. ,
Abstract: (19 Views)
Introduction: Moral injury is a form of psychological trauma experienced by healthcare workers, leading to guilt, shame, emotional distress, and reduced morale. This study evaluated the psychometric properties of the Persian version of the Moral Injury Symptoms Scale-Health Professional (P-MISS-HP) among Iranian nurses.
Methods: A cross-sectional study was conducted in 2025 in Urmia, Iran. The scale was translated using a forward–backward translation approach. Face, content, and construct validity were assessed in a sample of 220 nurses randomly divided into two groups. Exploratory factor analysis (EFA) using maximum likelihood and Oblimin rotation was conducted in one group; and confirmatory factor analysis (CFA) was performed in the other. Reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Convergent and discriminant validity were evaluated using average variance extracted (AVE), composite reliability (CR), maximum shared variance (MSV), and the Heterotrait-Monotrait (HTMT) ratio.
Results: EFA identified two factors, shame/guilt/condemnation and spiritual troubles, explaining 63.2% of the variance; one item was removed. CFA confirmed this two-factor model with strong fit indices (CMIN/DF = 1.424, CFI = 0.988, RMSEA = 0.062). Internal consistency was high (α = 0.901, ω = 0.904). Convergent validity (AVE > 0.50, CR > 0.90), and discriminant validity (MSV < AVE, HTMT = 0.621) were also confirmed
Conclusion: The Persian version of the Moral Injury Symptoms Scale-Health Professional demonstrated strong psychometric qualities and is a reliable instrument for assessing moral injury among Iranian nurses.
Methods: A cross-sectional study was conducted in 2025 in Urmia, Iran. The scale was translated using a forward–backward translation approach. Face, content, and construct validity were assessed in a sample of 220 nurses randomly divided into two groups. Exploratory factor analysis (EFA) using maximum likelihood and Oblimin rotation was conducted in one group; and confirmatory factor analysis (CFA) was performed in the other. Reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Convergent and discriminant validity were evaluated using average variance extracted (AVE), composite reliability (CR), maximum shared variance (MSV), and the Heterotrait-Monotrait (HTMT) ratio.
Results: EFA identified two factors, shame/guilt/condemnation and spiritual troubles, explaining 63.2% of the variance; one item was removed. CFA confirmed this two-factor model with strong fit indices (CMIN/DF = 1.424, CFI = 0.988, RMSEA = 0.062). Internal consistency was high (α = 0.901, ω = 0.904). Convergent validity (AVE > 0.50, CR > 0.90), and discriminant validity (MSV < AVE, HTMT = 0.621) were also confirmed
Conclusion: The Persian version of the Moral Injury Symptoms Scale-Health Professional demonstrated strong psychometric qualities and is a reliable instrument for assessing moral injury among Iranian nurses.
Type of Study: Research |
Subject:
Health Services Management
Received: 2025/10/5 | Accepted: 2026/02/17 | Published: 2026/03/6
Received: 2025/10/5 | Accepted: 2026/02/17 | Published: 2026/03/6
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