Luppo Kuillman

Re-assessing the validity of the Moral Sensitivity Questionnaire 31 2 in the data. Second, some correlations were biased such that the target construct could not be interpreted, as the full matrix of factor loadings was not presented. And third, several items were correlated with more than one construct of moral sensitivity, thereby violating the necessary condition that each item should exclusively tap an aspect of only one underlying construct or dimension. As a consequence of these problems, the indices of reliability or internal consistency (Cronbach’s alpha) for these six scales ranged from 0.36 to 0.61, thus indicating poor intercorrelations between the items. Other MSQ studies conducted in many different countries (Borhani, Abbaszadeh, Mohamadi, Ghasemi, & Hoseinabad-Farahani, 2017; Dalla Nora, Zoboli, & Vieira, 2017; Han, Kim, Kim, & Ahn, 2010; Yilmaz Sahin, Iyigun, & Acikel, 2015) have also evaluated the content and psychometric quality of a 30-item MSQ. These combinations of items proposed in these studies deviate from the latent constructs proposed by Lützén. As was the case with the instrument-testing performed by Lützén and colleagues, the aforementioned studies consisted exclusively of exploratory factor analysis (EFA). This method is not the most suitable for arriving at conclusive results about the factor structure of a scale, given that EFA based solely on the Kaiser criterion could potentially generate an excessively inclusive result (Fabrigar, Wegener, MacCallum, & Strahan, 1999). Thus, as the mixed results of the above studies suggest, there are still some unclarities about what the MSQ measures and how it should be used. On top of this, the 30-item MSQ has so far only been validated among psychiatrists and among nurses (Lützén et al., 1995; Lützén, Evertzon, & Nordin, 1997). However, it will be particularly interesting and relevant to develop and validate the MSQ among PAs and NPs. This is because these healthcare professionals have a special role that distinguishes them from nurses and doctors. As their responsibility lies in between that of MDs and nurses, their role is largely characterized by having medical-decisional responsibilities. In this role, both deliberate and paternalistic attitudes may take a prominent place in their professional identities. Indeed, in a feasibility study that we first performed, we found some indication that the MSQ administered among this specific group particularly distinguishes paternalistic and deliberative attitudes. We conducted this feasibility study among Master’s-level PA students (N = 32). By employing the method developed by Ruscio and Roche, (Ruscio & Roche, 2012) we found a two-factor structure. One of these factors apparently reflects a paternalistic attitude in decision-making, while the other reflects a deliberate attitude.