Moral Distress Among Long-Term Care Social Workers: Questionnaire Validation

Sagit Lev, Liat Ayalon

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: To describe the quantitative validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities in Israel. Method: Overall, 216 long-term care facilities’ social workers took part in the pilot study that included psychometric evaluation and construct validation. Moral distress was examined by two scales, measuring the frequency and the intensity of morally loaded events. A third scale was created, representing the product of the frequency and intensity scores for each item separately. Results: Two items with high floor effect were removed. The internal reliability of each of the three Moral Distress Scales was.92. An exploratory factor analysis suggested a single-factor solution. The construct validity was approved. In its final version, the questionnaire consisted of 15 items. Conclusions: We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research with regard to social workers’ moral conflicts and moral distress.

Original languageEnglish
Pages (from-to)628-637
Number of pages10
JournalResearch on Social Work Practice
Issue number5
StatePublished - 1 Jul 2018

Bibliographical note

Publisher Copyright:
© 2016, The Author(s) 2016.


  • construct validity
  • long-term care facilities
  • moral distress
  • questionnaire validation
  • social workers


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