Abstract
BACKGROUND: Registered nurses frequently face moral sufferings due to unavoidable ethical conflicts, which highlights the importance of moral resilience as a mitigating resource. A valid and reliable tool is essential to effectively measure moral resilience. AIM: The study aimed to translate, culturally adapt, and evaluate the psychometrics of the revised Rushton Moral Resilience Scale (RMRS) for use with Chinese registered nurses. STUDY DESIGN: A methodological study employing a cross-sectional survey design. PARTICIPANTS AND CONTEXT: A convenience sample of 432 Chinese registered nurses was recruited via an online survey platform from October to November 2023. ETHICAL CONSIDERATION: The study received approval from the Ethics Committees of Hunan Traditional Chinese Medical College (Approval number: YXLL202401004). CLINICAL TRIAL NUMBER: Not applicable. RESULTS: The revised RMRS was successfully translated and culturally adapted into the Chinese version. The scale-level content validity index (CVI) was 0.906, with item-level CVIs ranging from 0.833 to 1.000. Explanatory factor analysis (EFA) generated 12 items on a three-factor model for the revised Chinese version (Chi-RMRS-12). Confirmatory factor analysis (CFA) supported this structure, with factor loadings for each item ranging from 0.42 to 0.93. The scale demonstrated a Cronbach's α coefficient was 0.734, with dimensions ranging from 0.657 to 0.831, and a composite reliability (CR) coefficient of 0.902, with dimension-specific values from 0.628 to 0.811. Significant correlations were found among the Chi-RMRS-12, the Connor-Davidson Resilience Scale-10 (CD-RISC-10) and the Moral Distress Thermometer (MDT). DISCUSSION: The Chi-RMRS-12 effectively measures moral resilience of Chinese registered nurses, demonstrating strong validity and reliability. This scale can be used in research and practice to assess moral resilience, aiding nursing managers in monitoring the well-being of Chinese registered nurses and developing interventions to enhance their professional resilience and ensure quality of care.