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Validation of the German Version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) and Its Correlation to the Second Victim Phenomenon

Author

Listed:
  • Milena Trifunovic-Koenig

    (Institute for Infection Control and Infection Prevention, Health Care Association District of Constance, 78315 Konstanz, Germany
    These authors contributed equally to this work.)

  • Reinhard Strametz

    (Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
    These authors contributed equally to this work.)

  • Bianka Gerber

    (Institute for Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau Bodensee Hospital Singen, 78224 Singen, Germany)

  • Sneha Mantri

    (Department of Neurology and Trent Center for Bioethics, Humanities, and History of Medicine, Duke, University School of Medicine, Durham, NC 27710, USA)

  • Stefan Bushuven

    (Institute for Infection Control and Infection Prevention, Health Care Association District of Constance, 78315 Konstanz, Germany
    Hegau-Jugendwerk Hospital Gailingen, Health Care Association District of Constance, 78262 Konstanz, Germany
    Institute for Medical Education, University Hospital, Ludwig Maximilian University of Munich, 80331 Munich, Germany)

Abstract

Introduction: Comparable to second victim phenomenon (SVP), moral injury (MI) affects health professionals (HP) working in stressful environments. Information on how MI and SVP intercorrelate and their part in a psychological trauma complex is limited. We tested and validated a German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) instrument, screening for MI and correlated it with the recently developed German version of the Second Victim Experience and Support Tool (G-SVESTR) instrument, testing for SVP. Methods: After translating Moral Injury Symptom and Support Scale for Health Professionals (MISS-HP), we conducted a cross-sectional online survey providing G-MISS-HP and G-SVEST-R to HP. Statistics included Pearson’s interitem correlation, reliability analysis, principal axis factoring and principal components analysis with Promax rotation, confirmatory factor and ROC analyses. Results: A total of 244 persons responded, of whom 156 completed the survey (33% nurses, 16% physicians, 9% geriatric nurses, 7.1% speech and language therapists). Interitem and corrected item-scale correlations did not measure for one item sufficiently. It was, therefore, excluded from further analyses. The nine-item score revealed good reliability (Guttman’s lambda 2 = 0.80; Cronbach’s alpha = 0.79). Factor validity was demonstrated, indicating that a three-factor model from the original study might better represent the data compared with our two-factor model. Positive correlations between G-MISS-HP and G-SVESTR subscales demonstrated convergent validity. ROC revealed sensitivity of 89% and specificity of 63% for G-MISS-HP using a nine-item scale with cutoff value of 28.5 points. Positive and negative predictive values were 62% and 69%, respectively. Subgroup analyses did not reveal any differences. Conclusion: G-MISS-HP with nine items is a valid and reliable testing instrument for moral injury. However, strong intercorrelations of MI and SVP indicate the need for further research on the distinction of these phenomena.

Suggested Citation

  • Milena Trifunovic-Koenig & Reinhard Strametz & Bianka Gerber & Sneha Mantri & Stefan Bushuven, 2022. "Validation of the German Version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP) and Its Correlation to the Second Victim Phenomenon," IJERPH, MDPI, vol. 19(8), pages 1-19, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:8:p:4857-:d:795484
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    References listed on IDEAS

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    1. Reinhard Strametz & Johannes C. Fendel & Peter Koch & Hannah Roesner & Max Zilezinski & Stefan Bushuven & Matthias Raspe, 2021. "Prevalence of Second Victims, Risk Factors, and Support Strategies among German Nurses (SeViD-II Survey)," IJERPH, MDPI, vol. 18(20), pages 1-15, October.
    2. Isolde Martina Busch & Francesca Moretti & Irene Campagna & Roberto Benoni & Stefano Tardivo & Albert W. Wu & Michela Rimondini, 2021. "Promoting the Psychological Well-Being of Healthcare Providers Facing the Burden of Adverse Events: A Systematic Review of Second Victim Support Resources," IJERPH, MDPI, vol. 18(10), pages 1-17, May.
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    Cited by:

    1. Risto Nikunlaakso & Kirsikka Selander & Elina Weiste & Eveliina Korkiakangas & Maria Paavolainen & Tiina Koivisto & Jaana Laitinen, 2022. "Understanding Moral Distress among Eldercare Workers: A Scoping Review," IJERPH, MDPI, vol. 19(15), pages 1-14, July.
    2. Stefan Bushuven & Milena Trifunovic-Koenig & Michael Bentele & Stefanie Bentele & Reinhard Strametz & Victoria Klemm & Matthias Raspe, 2022. "Self-Assessment and Learning Motivation in the Second Victim Phenomenon," IJERPH, MDPI, vol. 19(23), pages 1-19, November.

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