Moral Distress and Interprofessional Collaboration Among Physicians, Nurses, and Social Workers

The purpose of this study was to elucidate the moral distress experienced by 180 medical professionals (80 doctors, 80 nurses, and 20 social workers) in an acute care hospital using the Japanese version of the moral distress scale Japanese version of moral distress scale-revised (JMDS-R), a revised version of the MDS-R developed in the United States. The survey was conducted in April 2020. A cross-sectional study was conducted using the Internet. Fourteen items of the JMDS-R were subjected to factor analysis (principal factor method, promax rotation) under three domains: “Lack of dignity,” “Lack of collaboration on continuous quality improvement,” and “Tacit acceptance of unethical behavior.” The Kaiser–Meyer–Olkin (KMO) sample validity was 0.914; the cumulative factor contribution rate was 79.05%, and the reliability coefficients (Cronbach’s alpha) were 0.92, 0.92, and 0.89 for the first, second, and third domains, respectively. When the occupations and domains of the JMDS-R were compared, it was found that there was a significant difference in the first factor, “Lack of dignity” (F6.71, p < 0.01), and in Tukey’s multiple comparisons, the scores of nurses and social workers were significantly higher than those of doctors (p < 0.01). Dialog is necessary to create opportunities for professional collaboration using common examples of the moral distress of each healthcare professional.