요양병원 간호사의 도덕적 고뇌 한국형 도구의 타당도와 신뢰도 분석

Abstract

본 연구의 목적은 요양병원 간호사의 한국형 도덕적 고뇌(MMD-K) 도구의 타당도과 신뢰도를 검증하기 위해서이다. 자료수집은 2020년 7월1일부터 10월 31일까지였으며, D, G, B시에 위치한 7개의 요양병원 간호사 중 현 기관에서 6개월 이상 근무경험이 있는 간호사 200명에게 수집되었다. SPSS WIN 21.0과 AMOS WIN 23.0을 이용하여 도구의 타당도와 신뢰도를 검증하였다. 탐색적 요인분석에서는 환자를 대하는 임상수준, 의료시스템, 팀 상호작용, 개인적 취약함의 4개의 요인으로 분류 되었다. 분류된 4개 요인으로 확인적 요인분석을 시행한 결과 X2/df 2.70, CFI .901, TLI .896, IFI .881, GFI .883, SRMR .073, RMSEA .075로 검증되었고, Cronbach의 ⍺는 .91로 확인하였다. 전문가 집단을 통한 내용타당도 지수는 .92였으며, 수렴타당도는 0.7을 넘는 0.71-0.86이었고, 변별타당도는 0.63-0.84로 0.5이상의 결과를 보여 타당도가 확보되었음을 확인하였다. 한국어판 도덕적 고뇌 (MMD-K)도구가 국내 요양병원 간호사의 도덕적 고뇌를 측정하기 유효한 도구임을 확인하였다.; Purpose: In this study the validity and reliability of the Korean version of the measure of moral distress(MMD-K) for nurses in long-term care hospital was investigated. Methods: Tool translation was carried out through the original tool translation and reverse translation process according to the proposal of the World Health Organization. Data were collected from 7 nursing hospitals located in D, G, and B from 200 nurses with at least 6 months of current institutional experience. In this study the validity, and reliability were verified using SPSS 21.0 and AMOS 23.0. Results: The exploratory factor analysis consisted of four factors: clinical causes at the patient level clinical level, medical system, team interaction, and personal vulnerability of the four factors in the confirmatory factor analysis. The Korean version of the measure of moral distress was validated by confirmatory factor analysis(X2/df 2.70, CFI .901, TLI .896, IFI .881, GFI .883, SRMR .073, RMSEA .075). Furthermore, the reliability verification showed Cronbach's ⍺= .91, confirming that the Korean version of the tool in this study was very reliable. The content validity index through the expert group was .92, the convergent validity was 0.71-0.86, which exceeded 0.7, and the discriminant validity was 0.63-0.84, confirming that validity was secured with a result of 0.5 or more. Conclusion: This study showed that the Korean version of the measure of moral distress (MMD-K) is a valid and reliable instrument to assess nurses in Korea long-term care hospital.