Moral comfort, an emerging concept in nursing, is defined as an individual’s feelings of ease with decisions and actions related to a moral dilemma. Moral comfort for nurses is the positive outcome of a moral situation or dilemma, while moral distress, a widely explored issue in nursing, is the negative outcome. However, nursing literature on the concept of moral comfort is limited. While several instruments to measure moral distress exist, an instrument to measure moral comfort was not found. The Moral Comfort Questionnaire (MCQ) was theoretically developed. The purpose of this study was psychometric evaluation of this new 35-item instrument. Direct-care hospital-based registered nurses (n = 466) participated from February 2019 to September 2019 in this IRB-approved study. Participants completed demographic information, the MCQ, and the Moral Distress Scale revised (MDSR). Psychometric evaluation included a priori content validation and multiple statistical analyses: Cronbach’s alpha, Spearman’s correlation coefficient, weighted kappa, Bland- Altman analysis (B&A), discriminant validity, and confirmatory factor analysis (CFA). / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

The purpose of this study is to gain a richer understanding of the experiences of moral distress for nursing students within the context of psychiatric-mental health clinical placements, examine strategies students use to effectively manage distress, and explore student and instructor roles as agents of change to reduce the negative impact of moral distress. Nursing students and instructors engaged in semi-structured interviews and focus groups, respectively, to examine the complexities of this phenomenon. This study utilized second-person action research based on Jürgen Habermas’ Theory of Communicative Action. Findings indicated that nursing students experience moral distress when they are powerless and lack role models to follow in taking action to address situations that are “not right”. Nursing instructors acknowledge their responsibility to prepare students for practice, but are also powerless as “guests” within the practice setting and are powerless to effect change on a hierarchical medical system. Findings indicate that both nursing education and health care institutions must make changes in their approaches to practice if they wish to empower nursing professionals to provide safe, competent, and ethical care to patients. / vii, 139 leaves ; 29 cm