Table 2 Rotated component Matrix for the Moral Distress Scale in Mental health nurses (Persian version)

a4

Assist the physician who does a test without patient permission and obtaining informed consent.

0.73

0.17

0.19

a1

Follow the family’s wishes for the patient’s care when the hospital management don’t agree with them, but do so because of fears of lawsuit.

0.72

0.23

0.26

a2

Follow the orders of the doctor, who prioritizes the preferences of the family over the patient.

0.67

0.29

0.26

a13

Hide meds in food and drink, when patients refuse to take them.

0.65

0.28

0.34

a7

Work with levels of healthcare staffing that I consider unsafe.

0.64

0.26

0.30

a10

Witness healthcare providers giving false hope or not telling the truth to a patient or family.

0.63

0.18

0.21

a6

Avoid taking action when I learn that a colleague has made a medical error and does not report it.

0.17

0.71

0.12

a9

Witness healthcare providers make fun of a patient and do nothing about it.

0.21

0.68

0.16

a3

Carry out medical orders for what I consider unnecessary tests and treatments.

0.19

0.63

0.25

a15

Work in an organization that not treating the nurses well.

0.16

0.60

0.33

a12

Provide less than optimal care to an unconscious patient because of being short-staffed.

0.33

0.57

0.08

a11

Witness and take no action for discharging of a patient that no longer needs to be there and is ready to get back to normal life.

0.24

0.23

0.78

a8

Provide less than optimal care due to pressures from administrators or insurers to reduce cost.

0.34

0.18

0.56

a5

Detecting and ignoring suspicious patient abuse and neglect by caregivers.

0.46

0.22

0.53

a14

Avoid talking to gentle and calm patients because of being overwhelmed at work.

0.27

0.26

0.51