Italian validation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP): A multicenter cross-sectional study

Alessandra Gorini, Monica Parati, Giulia Viganó, Filippo Marchetti, Luca Fiorentino, Daniele Marchetti, Lavinia Fiaschi, Giacomo Gualtieri, Monica Casati, Simonetta Cesa, Andrea Pozza, Department of Clinical Sciences and Community Health, Department of Excellence , University of Milan, Istituti Clinici Scientifici Maugeri IRCCS, PsyCaRe Lab, Cardiac Surgery Intensive Care Unit, Emergency Department, ASST Papa Giovanni XXIII, Department of Medicine, Surgery and Neuroscience, University of Siena, Directorate of Health and Social Professions, ASST Papa Giovanni XXIII, Emergency Room, University Hospital , Le Scotte, Psychology Unit, Azienda Ospedaliero-Universitaria Senese

Nursing Ethics: An International Journal for Health Care Professionals

Published online on December 01, 2025

Abstract

Nursing Ethics, Volume 33, Issue 3, Page 793-812, May 2026.
BackgroundMoral distress occurs when ethically appropriate actions cannot be implemented, resulting in cognitive and emotional strain linked to outcomes like burnout and staff turnover. Despite extensive cross-cultural validation of the Measure of Moral ...