Luppo Kuillman

Re-assessing the validity of the Moral Sensitivity Questionnaire 35 2 small effect size, with Rho in the range of ≥0.10 to <0.30 and Rho ≥0.30 to < 0.50, indicates a medium effect that is comparable to relevant effect sizes in terms of differences between two means (Cohen, 1988). Divergent validity was analyzed according to correlations between measurements of moral behavior that were expected to be unrelated (i.e., no statistically significant correlation). Measurements Sociodemographic characteristics In this study, the following sociodemographic characteristics were self-reported: age, gender, working environment, and religion. Moral Sensitivity Questionnaire In order to adjust the psychiatry oriented MSQ (Lützén et al., 1997) for use in research populations of NPs and PAs, it was necessary to rephrase nine items. For example, references to “psychiatrist” were replaced with references to either “NP” or “PA” in two items, and the terms “psychiatric care” and “psychiatric practice” were rephrased as “care” or “practice,” respectively, in five items. Furthermore, two items referring to “treatment under the Mental Health Act” were rephrased to refer to “care provided to incapacitated patients.” Respondents were asked to use a 7-point Likert scale (1 = fully disagree to 7 = fully agree) to indicate how they perceived their own manner of decision-making in moral dilemmas. Each of the items reflected either a paternalistic or deliberate attitude, as assumed in a previous feasibility study conducted among PA students. For each scale, item scores were coded, summed, and transformed into a scale ranging from 0 to 100 (with higher scores reflecting greater sensitivity or insensitivity) and calculated by subtracting the lowest possible scale score from the raw summed scale score, divided by the range of scores on the scale and multiplied by 100. The instruments used for testing the convergent and divergent validity of the hypothesized latent MSQ constructs (as found in the feasibility study), as described in Appendix 1, include the following: a) the BCPH scale; b) the EAS; c) the MDS, and d) the DIT-N2 (Ajzen I, 1991; Bandura A, 1996; Bandura A, 1999; Raaijmakers Q, Engels R, Van Hoof A, 2005; Rest J, Thoma SJ, Narvaez D, Bebeau MJ, 1997; Rest JR, 1990). All of the scales used in the current study were transformed towards normality through a two-step transformation process, conducted prior to the analyses (Templeton & Burney, 2016).