PHASE 1: Approximately 6 months (October 2016-March 2017)
The Moral Distress in Dementia Care Survey (MDDCS) was developed specifically for continuing care settings in a previous study, and its contents emerged from intensive qualitative interviews with nursing care providers in residential care settings. The survey has been slightly revised based on the findings from that first study. The newly revised instrument consists of four sections and a short section on demographics. The first section lists 28 different situations that may trigger moral distress and the respondent is asked to indicate the frequency of the situation, as well as the magnitude of moral distress caused. Respondents are also asked indicate their overall level of moral distress over the past year on a scale of 0-10. Section two of the survey lists potential effects on the respondent of moral distress and respondents are asked to indicate the frequency of experiencing the effect over the last year. Section three contains strategies that may mitigate moral distress, and respondents are asked to indicate how much they believe each strategy might reduce their feelings of moral distress. Section four consists of 3 items, related to job satisfaction and the implications of moral distress, as well intent to stay in the current job.
In the first part of Phase 1 (October-December 2016), the revised instrument was piloted in two care facilities with 68 nursing care providers. Although our first study provided data that gave us confidence in this instrument, it was important that we pilot the revisions/additions to the survey made since it was first developed. Data from this pilot has informed some revisions to the survey that we believe will make it clearer, and easier to complete.
Implementation of the survey across all facilities
One of the most important steps we have taken is to recruit a volunteer “champion” at each participating site to facilitate communication about the study, as well as to encourage the participation of staff and assist with data collection. This champion will help us ensure the frequent collection of completed surveys, and will be asked to mail the completed, anonymous surveys (which will be in sealed envelopes) to the researchers directly. This trusted champion will be entrusted with the key to the survey drop-box, and asked to sign an oath of confidentiality. With the help of these champions, we hope to complete this phase of the study on time, by the end of March 2017.