Luppo Kuillman

Chapter 2 40 (Falkum & Førde, 2001). Factor 1 thus represents a construct that we have labelled the “Paternalistic Attitude Scale” (MSQ-PATER), as the items reflect the thinking that one is acting in the patient’s best interest while disregarding the patient’s will in the matter. In this study, we defined the concept of paternalism as “a tendency to avoid empathizing with the patient’s dilemmas and taking decisions with a strong emphasis on rules and regulations, as well as on medical knowledge and practice, and based on professional opinions about the best treatment options”. Factor 2 represents a construct that we describe as the “Deliberate Attitude Scale” (MSQ-DELIB). All of the items in this scale center on the dimension of a professional relationship between the clinician and the patient, as indicated by such socio-cognitive, affective themes as “autonomy,” “relationship,” “giving respect,” and “providing patients with insight.” The concept of moral deliberation thus implies that NPs and PAs engage in careful and serious deliberation before making any important medical decisions. This finding is based on the independent content analysis of MSQ items. We defined the concept of moral deliberation, measured by the MSQ-DELIB as “medical decision-making aimed at helping patients to determine the best health-related values that can be realized in the clinical situation after consider- able deliberation.” The new scales and their assigned items are presented in Figure 1, along with (a) their respective standardized regression weights (i.e., factor loadings) from latent constructs to the variables measured and (b) their standard errors. All beta weights were statistically significant (p < .001). Both the “MSQ-PATER” and the “MSQ- DELIB” scales had internal consistency of 0.70