Italian validation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP): A multicenter cross-sectional study.

This article focuses on the cultural adaptation and psychometric validation of the Italian version of the Measure of Moral Distress for Healthcare Professionals (MMD-HP-ITA), a tool designed to assess moral distress—defined as the psychological distress experienced when healthcare professionals cannot act according to their ethical judgment. Conducted in two major Italian university-affiliated hospitals with 567 healthcare professionals (predominantly nurses), the study found that the MMD-HP-ITA demonstrated excellent internal consistency (Cronbach's α = 0.96) and construct validity, with moral distress scores varying by professional role, age, and intention to leave the job. Exploratory factor analysis supported a three-factor structure—team-level dynamics, system-level constraints, and patient/family-level conflicts—differing from the original four-factor model but aligning with other international validations, suggesting cultural and organizational influences on the experience of moral distress. The validated Italian instrument offers a reliable, culturally sensitive measure to identify sources of moral distress in healthcare settings, potentially guiding targeted interventions to improve ethical climates and reduce burnout.