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Table 3 Categorization and item tracking matrix the process of categorisation and reduction of items

From: Outcomes of Moral Case Deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD)

Stages Domains Subdomains Items at each step n Coding agreement Revision of items n
      A* B C
Collection of items    96 - - - -
MS and BM categorisation Reduced moral distress Emotional support 48 50% 24 36 20
   Better ability to prioritise      
   Received support to handle ethical problems      
  Enhanced ethical climate Organisation consistent with ethical standards      
   Enhanced collaboration      
   Enhanced communication      
  Concrete resolution in patient cases Answers or consensus reached in the patient cases      
   Concrete steps taken in the patient cases      
   Improved process for decision making in the patient cases      
  Enhanced moral competence Improved moral skills      
   Improved moral attitude      
   Improved ethics knowledge      
Delphi round 1: Enhanced emotional support (Subdomains discarded and abstraction level for domains lowered) 33 25% 6 10 29
  Improved cooperation & communication      
  Better coherence with organizational policy      
  Clear results      
  Improved moral skills      
  Improved moral attitude      
Delphi round 2 Enhanced emotional support (Meaning of one domain was changed and three domains were reformulated) 26 75% 4 6 18
  Enhanced collaboration      
  Improvement on organizational level      
  Concrete results      
  Improved moral reflexivity      
  Improved moral attitude      
  1. *A = merged, B = discarded, C = reformulated.