Development and validation of the Nurse’s Workplace Mental Health Questionnaire

ObjectivesThis study aimed to develop and validate the Nurse’s Workplace Mental Health Questionnaire (NWMHQ).MethodsThe questionnaire was developed based on the two continua model of mental illness and health proposed by Keyes. The initial questionnaire was generated through literature review, two rounds of Delphi expert consultation, followed by a pilot survey. Finally, the reliability and validity of the questionnaire were validated through an online survey of 2,815 registered nurses selected from the public hospitals in 11 provinces from June to July 2020.ResultsThe item-content validity index (I-CVI) of the questionnaire ranged from 0.750 to 1.000 and the average scale-level content validity index (S-CVI/Ave) was 0.906. Cronbach’s α coefficient was 0.948 and test-retest reliability was 0.850. The self-rating depression scale score was negatively related to the NWMHQ score (r = −0.664, P < 0.01). The exploratory factor analysis (EFA) yielded six factors (emotional status, psychological security, positive relationship, resilience, self-efficacy, and subjective well-being), consisting of 32 items. The cumulative variance contribution rate was 65.58%. Confirmatory factor analysis (CFA) showed an acceptable fit.ConclusionThe NWMHQ developed in this study showed good reliability and validity. This questionnaire may help assess the mental health status of nurses and help nursing managers to develop appropriate targeted psychological interventions.     

The Turkish version of the Casey-Fink Readiness for Practice Scale: A validity and reliability study

AimThe aim was to translate and adapt the Casey-Fink Readiness for Practice Scale (CFRPS) into Turkish and assess its validity and reliability for senior nursing students.BackgroundNursing students’ readiness for practice is important for quality nursing care and to support new graduate nurses and orient them quickly for their professional life. Nurse educators and nurse managers are responsible for develop nursing students’ and new graduate nurses’ readiness for practice. Currently, there is no valid and reliable tool to assess this metric for senior nursing students in Turkey.DesignThe study was conducted using a methodological approach.MethodsThe sample of the study consisted of 179 students who were enrolled in the last year of nursing school across three state universities in one region of Turkey. A socio-demographic form and the Turkish version of the CFRPS were used for data collection. Data were collected online between 12 April – 17 May 2021. Content validity was assessed using expert approval. Confirmatory factor analysis, exploratory factor analysis and structural equation modelling were used to assess validity. Cronbach's alpha and test–retest were performed to assess reliability.ResultsNursing students’ mean age was found to be 22.3 ± 1.12. The content validity index of the scale was calculated as 0.94. Confirmatory and exploratory factor analysis identified 15 items, which could be categorized under one factor, that were obtained differently from the original scale. The factor loads were found to be between 0.39 and 0.70. The Cronbach's alpha of the scale was 0.881. One factor model achieved a good fit.ConclusionsThe study demonstrated that the Turkish version of the CFRPS is a valid and reliable assessment tool to evaluate senior nursing students’ readiness for practice. Information in the Turkish version of the CFRPS was obtained differently from the original scale. Nurse educators can use this tool to assess their students’ progress in readiness for practice before they graduate.     

Association between COVID-19-related stress and self-directed learning ability among Korean nursing students

PurposeTraditional face-to-face classes for nursing students due to the COVID (Coronavirus Disease)-19 pandemic around the world made it inevitable to operate education delivery method using remote/hybrid fashion. This study was aimed to validate the Korean version of the Student Stress Inventory-Stress Manifestations (SSI-SM) and assess the association between COVID-19 pandemic related stress level and self-directed learning ability competence in nursing students.DesignThis research was a cross-sectional study design.MethodsThe study was conducted from December 2020 to January 2021, with a convenience sample of 172 nursing students in the 3rd and 4th grades in South Korea. The Korean version of SSI-SM(K-SSI-SM) was translated and adapted according to standard guideline, and tested construct validity and reliability. In addition, a multiple linear regression analysis was used to examine the associations between the COVID-19 related stress level and the self-directed learning ability.ResultsAn exploratory analysis showed that K-SSI-SM composed of 13-item in three factors (uncertainty, non-sociability, and somatization) accounted for 68.73% of the total variance after it was modified. The internal consistency was good with 0.91. Multiple linear regression analysis revealed that higher self-directed learning ability was associated with lower stress levels (β = −0.19, p = 0.008), positive toward online learning (β = 0.41, p = 0.003) and scored higher in theory (β = 0.30, p < 0.001) in nursing students.ConclusionThe K-SSI-SM is an acceptable instrument for assessing stress levels in Korean nursing students. And nursing faculties need to pay attention to related factors of self-directed learning ability, in order to achieve the course's self-directed learning goal in students attending online classes.     

Core Competence in Fundamental Nursing Practicum Scale: A validity and reliability analysis

AimThis study aimed to develop and examine the psychometric properties of validity and reliability of the Core Competence in Fundamental Nursing Practicum Scale.BackgroundFundamental nursing practicum is an initial practicum required for nursing students; however, no measurement tool is available to assess students’ core competence during their first practicum.DesignCross-sectional design.MethodsNursing students from six nursing colleges in Southern Taiwan who completed their fundamental nursing practicum within 1 month were recruited. The initial 39-item Core Competence in Fundamental Nursing Practicum Scale was drafted and examined for its content, face and factorial validity. The data were randomly assigned into two subgroups and analyzed using exploratory and confirmatory factor analyses. Exploratory factor analysis was performed using principal-axis factoring and direct oblimin rotation and numbers of factors were extracted on the basis of eigenvalues > 1 and a scree plot. The exploratory factor analysis derived structure was then verified by a confirmatory factor analysis using maximum likelihood estimation. Reliability was examined in term of internal consistency.ResultsThe exploratory factor analysis and confirmatory factor analysis samples comprised 405 and 513 students, respectively. Four items were omitted by content validity and another four items were omitted because of the ceiling effect. Six items were removed during the exploratory factor analysis because of their lower factor loadings (< 0.4). The final 25-item Core Competence in Fundamental Nursing Practicum Scale comprised 5 domains, namely communication (3 items), application of nursing process (6 items), basic biomedical science (4 items), nursing skills and ability to perform a care process (7 items), and professional attitude (5 items), which collectively explained 70.14% of total variance. The structure was then verified by a confirmatory factor analysis with satisfactory model fit. The Cronbach’s alpha of the Core Competence in Fundamental Nursing Practicum Scale was 0.94.ConclusionsThe 25-item Core Competence in Fundamental Nursing Practicum Scale reliably and validly measures nursing students’ core competence during their fundamental nursing practicum. Instructors can use the scale to identify students’ weak core competencies and refine their courses for novice nurses.     

Academic goals orientation questionnaire for Colombian nursing students: Validity and reliability study

BackgroundAcademic motivation guides students toward the achievement of academic objectives and influences their learning. However, there is little research on this subject in nursing education, and validated instruments are not available in Latin America.ObjectiveTo determine the validity and reliability of the Academic Goals Orientation Questionnaire in Colombian nursing students.DesignCross-sectional psychometric study developed in the second semester of 2016.Settings and participants.Undergraduate students in nursing at the National University of Colombia (n = 323).MethodsThe Academic Goals Orientation Questionnaire was administered electronically. In addition, the variables of age, sex and academic year were collected. An analysis of construct validity was carried out by exploratory and confirmatory factor analysis. The reliability of the questionnaire was studied with Cronbach's alpha.ResultsThe exploratory factor analysis revealed the presence of four factors that explain 53.4% of the total variance and that correspond to the dimensions of the original instrument. The overall reliability was α = 0.714. The confirmatory factor analysis verified a good fit of the model (χ² = 128, p = .024); its standardized mean square residue (SRMR) was 0.0471; the root mean square error of approximation (RMSEA) was 0.03 (IC95% = 0.011–0.044), and the comparative fit index (CFI) was 0.972. The learning or task goal obtained the highest average score (m = 4.67, 95% CI = 4.629–4.712), and the Work avoidance goal was the worst rated (m = 2.126, 95% CI = 2.055–2.198) by the students.ConclusionThe Academic Goal Orientation Questionnaire has an adequate validity and reliability in the Colombian context that allows it to be applied in nursing students. However, it is recommended to expand the study with larger samples and other countries in the same context.     

Perceived professional preparedness of senior nursing students' questionnaire: Development and psychometric evaluation

BackgroundNursing students' perceptions of their professional preparedness help them perform their independent nursing role with self-confidence.ObjectivesTo develop and psychometric testing of an instrument, the “Perceived Professional Preparedness of senior Nursing Students” questionnaire.DesignMixed-method exploratory study.MethodsWe conducted this study in two phases: (1) development of initial questionnaire through interview and literature review; (2) evaluation of psychometric properties of the instrument to introduce a reliable, valid tool.Settings and participantsWe assessed qualitative and quantitative face validity of initial questionnaire by administering it to 10 nursing students. Then, a panel of 10 nursing specialists determined the Content Validity Index. After modifying items, we assessed the construct validity of the 45-item questionnaire. A sample of 159 senior nursing students completed the questionnaire, and we conducted exploratory and confirmatory factor analysis using this data. To assess the test-retest reliability, 30 students completed the instrument twice with a two-week time interval.ResultsThe Content Validity Index with the modified Kappa coefficient was calculated as ≥0.72, which is considered satisfactory. In exploratory factor analysis using the maximum likelihood method and varimax rotation, we extracted 19 items in four factors. This structure included 61.91% of the total variance. The factors were clinical competency, evidence-based practice, framework-oriented performance, and patient-centered care. Cronbach's alpha coefficient and McDonald's omega values higher than 0.70 and inter-class correlation coefficient above 0.90 for all factors confirmed reliability. Confirmatory factor analysis indicated a suitable fitting of the final developed model.ConclusionThe developed questionnaire is a valid, reliable tool to assess the perceived preparedness of senior nursing students for transition to the clinical setting. Further psychometric testing for this questionnaire on larger populations and in different contexts is suggested.     

Effective online learning strategies for leadership and policy undergraduate courses for nursing students: a rapid review

ObjectivesDue to the importance of developing leadership competencies during nursing education, it is critical to make evidence-based decisions regarding the transformation from face-to-face to online delivery of leadership and policy courses for nursing students in the wake of the COVID-19 pandemic. This rapid review aims to identify effective learning strategies for creating online leadership and policy courses for undergraduate nursing students.Data sources and review methodsA rapid review methodology was used. Searches in CINAHL and ERIC yielded 4112 records. After screening, seven articles were included. The Criteria for Describing and Evaluating Training Interventions in Healthcare Professions (CRe-DEPTH) tool was used for quality appraisal and data extraction. A narrative synthesis approach was used to summarize the data.ResultsThe learning activities were heterogeneous in terms of content and format. Articles described the use of discussion forums, case studies, virtual clinical learning experiences, microblogging, and video clips. The methods of evaluation for these learning activities also varied greatly.ConclusionThe findings will act as a steppingstone to help develop an online undergraduate leadership and policy nursing course. This review also demonstrated the need for rigorous evaluation of learning activities. The use of a tool such as the CRe-DEPTH can help instructors plan and report on their learning interventions or courses.     

Psychometric evaluation of the Chinese version of motivation for nursing student scale (MNSS): A quantitative and cross-sectional design

BackgroundAcademic motivation is the psychological factor that promotes learning activities. The persistence of learning activities in nursing education is directly influenced by academic motivation. However, there are currently no specialist instruments for nursing students in China.ObjectiveTo translate the Motivation for nursing student scale (MNSS) into Chinese and evaluate its validity and reliability among nursing students in China.DesignA quantitative and cross-sectional design.SettingThe survey was conducted at a medical university in Jinzhou, China between March and May 2022.ParticipantsA total of 688 Chinese nursing students were surveyed by questionnaire in this study.MethodThe Chinese version of MNSS adopted Brislin's transition model and conducted expert consultations to validate the facial validity and testing of the transition version. Reliability and validity were tested using exploratory factor analysis, confirmatory factor analysis, and internal consistency reliability.ResultsNursing experts confirm the high content validity of the Chinese version of the 20-item scale. An exploratory factorial analysis revealed a four-factor solution, with a total variance of 64.1% and confirmatory factor analysis results showed a satisfactory fit (χ2/df=2.738, RMSEA =0.073, SRMR = 0.0719, CFI = 0.914, IFI = 0.915, NFI =0.872, RFI =0.849,). Cronbach's alpha coefficient for the scale was 0.869, and the split-half reliability is 0.727.ConclusionThe Chinese version of MNSS has satisfactory reliability and validity and is a reliable instrument to assess the academic motivation of Chinese nursing students.     

Development and psychometric testing of the preceptors’ orientation competence instrument (POCI)

AimTo develop and psychometrically test a Preceptors’ Orientation Competence Instrument measuring orientation competence of nurses working as new employee preceptors.BackgroundCompetence of nurse preceptor is essential for a successful preceptorship and thus nursing staff´s commitment to the organization.DesignInstrument development according to the COSMIN guidelines.Methods and participantsFour phases were implemented: 1) establishment of the theoretical framework, modification of the validated Mentor Competence Instrument and generation of new items; 2) content validity testing; 3) structural validity testing; and 4) internal consistency testing. Content validity was evaluated by 14 experts using content validity index methods. Structural validity was evaluated using exploratory factor analysis with a convenience sample of 844 Finnish nurses. Internal consistency was evaluated by measuring Cronbach’s alpha.ResultsThe content validity index of subdimensions of the instrument ranged from 0.80 to 0.94 for relevance and 0.80–0.94 for clarity. Exploratory factor analysis resulted in a seven-factor model with 53 items (61.62% of total variance): preceptor characteristics, goal-oriented orientation, guidance in reflective discussion, knowledge of work unit orientation practices, creation of a supportive learning atmosphere, preceptor motivation and giving of developmental feedback. Cronbach’s alpha values varied from 0.79 to 0.93.ConclusionPreceptors’ Orientation Competence Instrument demonstrated adequate psychometric properties based on content and construct validity as well as internal consistency. Therefore, it is useful for self-evaluation of orientation competence of nurses working as new employee preceptors.     

Adoption of new practice standards in nursing: Revalidation of a tool to measure performance using the Australian registered nurse standards for practice

BackgroundIn Australia, performance of nursing students during clinical placements is assessed against national practice standards. Access to a tool that has a common assessment language can reduce confusion across assessors, practice areas and programmes of nursing.AimTo revise the existing Australian Nursing Standards Assessment Tool (ANSAT) to reflect the 2016 Nursing and Midwifery Board of Australia (NMBA) registered nurse standards for practice and investigate validity of the revised tool.DesignNon-experimental study involving tool development and psychometric testing.Participants/settingRegistered nurses experienced in assessment of students from academic and clinical settings participated in the first phase of study; ANSAT scores of students across three universities were used for the second phase.MethodsA two-phased study was conducted. Phase one involved tool revision and content validation using a modified Delphi approach. Phase two involved validation of the revised tool used to assess student performance on clinical placement.ResultsA 23-item tool was developed in phase one from input of eight experts, with the content validity ≥.83. The phase two field test analysed 7696 completed tools. Exploratory factor analysis extracted one factor labelled professional practice performance. The revised ANSAT demonstrated high internal consistency (Cronbach’s alpha = .985). Comparison of mean total ANSAT scores determined the tool is sensitive to differing levels of performance across year levels, placement length, and sites with statistical significance observed at p < .001.ConclusionsThe revised ANSAT is a valid tool with high internal consistency that can be used to measure performance against NMBA registered nurse standards for practice.     

The development and psychometric testing of a Disaster Response Self-Efficacy Scale among undergraduate nursing students

BackgroundDisaster nurse education has received increasing importance in China. Knowing the abilities of disaster response in undergraduate nursing students is beneficial to promote teaching and learning. However, there are few valid and reliable tools that measure the abilities of disaster response in undergraduate nursing students.ObjectivesTo develop a self-report scale of self-efficacy in disaster response for Chinese undergraduate nursing students and test its psychometric properties.Participants and SettingsNursing students (N = 318) from two medical colleges were chosen by purposive sampling.MethodsThe Disaster Response Self-Efficacy Scale (DRSES) was developed and psychometrically tested. Reliability and content validity were studied. Construct validity was tested by exploratory and confirmatory factor analysis. Reliability was tested by internal consistency and test-retest reliability.ResultsThe DRSES consisted of 3 factors and 19 items with a 5-point rating. The content validity was 0.91, Cronbach's alpha coefficient was 0.912, and the intraclass correlation coefficient for test-retest reliability was 0.953. The construct validity was good (χ²/df = 2.440, RMSEA = 0.068, NFI = 0.907, CFI = 0.942, IFI = 0.430, p < 0.001).ConclusionsThe newly developed DRSES has proven good reliability and validity. It could therefore be used as an assessment tool to evaluate self-efficacy in disaster response for Chinese undergraduate nursing students.     

Psychometric Evaluation of the Korean Version of the Student Evidence-Based Practice Questionnaire (S-EBPQ)

PurposeEvidence-based practice (EBP) is a key competency that undergraduate nursing students need to learn, as EBP competence is essential for the effective implementation of EBP. However, few studies have comprehensively assessed the aspects of EBP competence using a reliable and valid measure specific to Korean nursing students. This study aimed to translate the Student Evidence-Based Practice Questionnaire (S-EBPQ) into Korean and evaluate its psychometric properties.MethodsThe original S-EBPQ was translated into Korean. After a pilot test, a convenience sample of 249 college students with more than four weeks of clinical training experience was selected from three universities in September 2017. Reliability and construct validity were evaluated using exploratory and confirmatory factor analyses. Concurrent validity was evaluated by correlating the measure with informatics competency.ResultsThe exploratory factor analysis revealed four factors that explained 66.3 of the variance. The confirmatory factor analysis yielded a 4-factor structure (χ²/df = 1.52, p < .001, standardized root-mean-square residual = .07, root-mean-square error of approximation = .07, goodness of fit index = .84, comparative fit index = .91). The Cronbach’s α was .81 for the total scale. The scale’s correlation with informatics competency was r = .55.ConclusionsThe Korean S-EBPQ is a reliable and valid tool that has utility for assessing EBP competence in Korean nursing students and for making comparisons of the EBP competence of nursing students from other countries.     

The Nurses Self-Concept Instrument (NSCI): assessment of psychometric properties for Australian domestic and international student nurses

BackgroundProfessional self-concept is a critical driver of job satisfaction. In Australia, as international nursing enrolments rise, nursing is increasingly characterised by a professional body of international nurses who may differ from domestic Australian nurses in their nursing self-concept. At present, no psychometrically sound instrument for assessing nursing self-concept for Australian domestic and international nursing students is available.PurposeThe purpose of this study was to: (1) develop an instrument (the Nurses’ Self-Concept Instrument (NSCI)) to measure the professional self-concept of domestic and international nursing students in Australia, and (2) test the psychometric properties of this newly developed instrument.MethodA literature review was conducted to generate the initial dimension and item pools to measure nurses’ professional self-concept (NSCI). Two stakeholders examined the content and face validity of dimensions and items. Analysis was performed on data collected from 253 undergraduate nursing students in a large public university in Sydney, Australia, and consisted of domestic (n = 218) and international (n = 35) nursing students. Internal reliability was assessed using Cronbach's Alpha. Confirmatory factor analysis (CFA) was used to assess the construct validity of the NSCI.ResultsThe resulting NSCI consisted of 14 items across four self-concept domains: care, leadership, staff relations, and knowledge. The CFA supported the hypothesised factor structure of the self-concept model. All reliabilities were acceptable for both domestic and international students (ranging from r = .78 to .93).ConclusionsThe NSCI was shown to be a valid and reliable tool for assessing Australian domestic and international student nurses’ professional self-concept. This instrument may also enable those responsible for recruitment of students into nursing courses to assess students’ professional self-concept and implement appropriate strategies to foster the growth of lifelong career development.     

Development of the Nursing Practice Readiness Scale for new graduate nurses: A methodological study

AimTo develop a scale to assess nursing practice readiness and verify its validity and reliability.BackgroundPractice readiness refers to the attitude and characteristics of new employees that enable them to successfully adapt to the workplace. For new graduate nurses to receive on-the-job training appropriate to their individual competency level, a scale to assess nursing practice readiness is needed.DesignA methodological study was conducted in two phases: (1) development of the scale through a literature review and interviews related to nursing practice readiness; (2) confirming construct validity, criterion-related validity and reliability of the developed scale.MethodsData were collected from 430 new graduate nurses in South Korea. The validity and reliability of the scale were verified using maximum likelihood exploratory factor analysis with promax factor rotation, confirmatory factor analysis using maximum likelihood estimation, Pearson correlation, analysis of variance and Cronbach’s alpha.ResultsThe Nursing Practice Readiness Scale consisted of 35 items for five factors: clinical judgment and nursing performance, professional attitudes, patient-centeredness, self-regulation and collaborative interpersonal relationship. Confirmatory factor analysis results revealed an adequate model fit. Construct validity and criterion-related validity were verified and all factors achieved a Cronbach’s α greater than 0.80.ConclusionsThe developed scale can evaluate educational outcomes and determine the need for additional support, which can improve the workplace adaptation of new graduate nurses, patient safety and quality of care.     

Peer learning a pedagogical approach to enhance online learning: A qualitative exploration

BackgroundFlexible online programs are becoming increasingly popular method of education for students, allowing them to complete programs in their own time and cater for lifestyle differences. A mixture of delivery modes is one way which allows for enhanced learning. Peer learning is another method of learning which is shown to foster collaboration and prepare healthcare students for their future careers. This paper reports on a project to combine peer and online learning to teach pharmacology to nursing students.ObjectivesTo explore undergraduate nursing student opinions of working in peer groups for online learning sessions in a pharmacology course.DesignA qualitative study utilising a self-reported questionnaire.SettingA rural campus of an Australian university.ParticipantsSecond year nursing students enrolled in a Bachelor of Nursing Program.MethodsA hard copy questionnaire was distributed to all students who attended the final semester lecture for the course. Content analysis of open-ended survey questions was used to identify themes in the written data.ResultsOf the 61 students enrolled in the nursing subject, 35 students chose to complete the survey (57%). Students reported a mixed view of the benefits and disadvantages of peer online learning. Sixty 6% (66%) of students liked peer online learning, whilst 29% disliked it and 6% were undecided. Convenience and ease of completion were reported as the most common reason to like peer online learning, whilst Information Technology issues, communication and non-preferred learning method were reasons for not liking peer online learning.ConclusionPeer online learning groups’ acted as one further method to facilitate student learning experiences. Blending peer online learning with traditional face-to-face learning increases the variety of learning methods available to students to enhance their overall learning experience.     

Hospital mortality and optimality of nursing workload: A study on the predictive validity of the RAFAELA Nursing Intensity and Staffing system

BackgroundPatient classification systems have been developed to manage workloads by estimating the need for nursing resources through the identification and quantification of individual patients’ care needs. There is in use a diverse variety of patient classification systems. Most of them lack validity and reliability testing and evidence of the relationship to nursing outcomes.ObjectivePredictive validity of the RAFAELA system was tested by examining whether hospital mortality can be predicted by the optimality of nursing workload.MethodsIn this cross-sectional retrospective observational study, monthly mortality statistics and reports of daily registrations from the RAFAELA system were gathered from 34 inpatient units of two acute care hospitals in 2012 and 2013 (n = 732). The association of hospital mortality with the chosen predictors (hospital, average daily patient to nurse ratio, average daily nursing workload and average daily workload optimality) was examined by negative binomial regression analyses.ResultsCompared to the incidence rate of death in the months of overstaffing when average daily nursing workload was below the optimal level, the incidence rate was nearly fivefold when average daily nursing workload was at the optimal level (IRR 4.79, 95% CI 1.57–14.67, p = 0.006) and 13-fold in the months of understaffing when average daily nursing workload was above the optimal level (IRR 12.97, 95% CI 2.86–58.88, p = 0.001).ConclusionsHospital mortality can be predicted by the RAFAELA system. This study rendered additional confirmation for the predictive validity of this patient classification system. In future, larger studies with a wider variety of nurse sensitive outcomes and multiple risk adjustments are needed. Future research should also focus on other important criteria for an adequate nursing workforce management tool such as simplicity, efficiency and acceptability.