Adaptation and Validation of a Moral Distress Instrument in Mental Health Nurses

Background and Purpose: To adapt and validate the Brazilian Scale of Moral Distress in Nurses for the mental health field. Methods: A cross-sectional methodological study was carried out, adapted with the contribution of 34 specialists, and validated by 173 mental health nurses. Results: The validated scale consists of 37 items divided into seven factors, and they were responsible for 77.2% of variance-working conditions, advocacy for the values and rights, professional safety and autonomy, ethical violations, social conflicts, ethical-professional competence, and conflicts with the management, with Cronbach's alpha at .972 for the entire instrument, and ranging from .852 to .949 for the constructs. Conclusion: The results provide evidence that the adapted instrument is reliable, valid, and consistent in measuring moral distress in mental health nurses.

Intensity and frequency of moral distress in mental health nurses in Brazil

OBJECTIVE

To assess the intensity and frequency of moral distress in mental health nurses in Brazil.

METHOD

Cross-sectional study with 173 nurses from the Psychosocial Care Network in Brazil. The Brazilian Scale of Moral Distress in Nurses, adapted for the context of mental health, was used. For data processing, descriptive and inferential statistical analysis was used.

RESULTS

Mostly moderate levels of intensity and frequency of moral distress (medians between 2.25 - 3.73 and 2.00 - 3.22, respectively) were observed, with emphasis on the factors working conditions and social conflicts.

CONCLUSION

The level of moral distress evidenced in mental health nurses in Brazil reflects the dimension and amplitude of the phenomenon in different points of the Psychosocial Care Network. The relevance of discussions on coping strategies for moral distress is highlighted, articulating elements such as sensitivity, resilience, and moral courage, so that ethical deliberation is applied in care and management settings.

Psicoterapia, neuroplasticidade e o funcionamento cerebral

Trata-se de uma revisão narrativa da literatura, cujo objetivo é descrever a relação entre psicoterapia, neuroplasticidade e o funcionamento cerebral. Ao realizar as buscas em diferentes bases de dados, evidenciou-se que as psicoterapias são emergentes de um longo processo histórico, associado à construção do conhecimento científico. Constituem um recurso terapêutico empregado na área da saúde, se apresentando sob diferentes concepções teóricas e modelos de atuação, estando indicadas ao tratamento de transtornos mentais e problemas de origem emocional, como método de escolha ou adjuvante a outras formas de tratamento. O curso científico traçado por pesquisadores para compreender o funcionamento cerebral associado à psicoterapia, remonta uma trajetória de significativos progressos, dentre eles o conhecimento sobre a neuroplasticidade, que faz menção à relação entre a experiência, fatores sociais, aprendizado e cérebro. Considera-se, portanto, se que a psicoterapia tem papel preponderante na modificação do funcionamento cerebral por meio da plasticidade neuronal, conforme evidenciado por estudos de neuroimagem. Para tanto, sugere-se que sejam realizadas mais investigações sobre o impacto da psicoterapia no funcionamento cerebral, especialmente, para refinar o arsenal científico que abrange os transtornos mentais e a prática na clínica do psicoterapeuta.