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34 HEC F. 1 (2022)

handle is hein.journals/hecforum34 and id is 1 raw text is: HEC Forum (2022) 34:1-24
https://doi.org/1 0.1007/si 0730-020-09421-9
Field-Testing the Euro-MCD Instrument: Important
Outcomes According to Participants Before and After Moral
Case Deliberation
J. C. de Snoo-Trimp'  . A. C. Molewijk'2  . M. Svantesson3-
G. A. M. Widdershoven  . H. C. W. de Vet4
Published online: 8 August 2020
ŠThe Author(s) 2020
Abstract
Ethics support services like Moral Case Deliberation (MCD) intend to support
healthcare professionals in ethically difficult situations. To assess outcomes of MCD,
the Euro-MCD Instrument has been developed. Field studies to test this instrument
are needed and have been conducted, examining important outcomes before MCD
participation and experienced outcomes. The current study aimed to (1) describe
how participants' perceive the importance of MCD outcomes after MCD; (2) com-
pare these perceptions with those before MCD participation; and (3) test the fac-
tor structure of these outcomes. Swedish, Norwegian and Dutch healthcare profes-
sionals rated the importance of outcomes in the Euro-MCD Instrument after four
and eight MCDs. Ratings were compared with those before MCD participation
using paired and independent samples t-tests. The factor structure was tested using
exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respond-
ents completed the instrument. More than 69% rated all MCD outcomes as 'quite'
or 'very' important, especially outcomes from Enhanced Collaboration, Improved
Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 out-
comes regarding ratings before and after MCD participation were not considered
meaningful. Factor analyses suggested three categories, which seemingly resemble
the domains Improved Moral Reflexivity, Enhanced Collaboration and a combina-
tion of Improved Moral Attitude and Enhanced Emotional Support. After partici-
pation in MCDs, respondents confirmed the importance of outcomes in the Euro-
MCD Instrument. The question on perceived importance and the categorization of
outcomes need reconsideration. The revised instrument will be presented elsewhere,
based on all field studies and theoretical reflections.
Keywords Clinical ethics support - Moral case deliberation - Evaluation-
Outcomes - Factor analyses
E J. C. de Snoo-Trimp
j.desnoo@amsterdamumc.nl
Extended author information available on the last page of the article

I_) Springer