Development of the Holistic Nursing Competence Scale

This study developed a scale to measure the nursing competence of Japanese registered nurses and to test its psychometric properties. Following the derivation of scale items and pilot testing, the final version of the scale was administered to 331 nurses to establish its internal consistency, as well as its construct and criterion-related validity. Using an exploratory and a confirmatory factor analysis, 36 items with a five-factor structure were retained to form the Holistic Nursing Competence Scale. These factors illustrate nurses' general aptitude and their competencies in staff education and management, ethical practice, the provision of nursing care, and professional development. The Scale has a positive correlation with the length of clinical experience. A Cronbach's alpha coefficient was 0.967. The Scale is a reliable and valid measure, helping both nurses and organizations to correctly evaluate nurses' competence and identify their needs for professional development.     

The Turkish version of the Newcastle Satisfaction with Nursing Care Scale used on medical and surgical patients

Aim and objectives. The aim of this study is to test the validity and reliability of the modified version of the Newcastle Satisfaction with Nursing Care Scale on medical and surgical patients. Background. Measuring patient satisfaction with nursing care is important in evaluating the extent to which patients’ needs are met and for determining the appropriate nursing care. In recent years there has been increasing interest in patient satisfaction with nursing care in Turkey, but there are no validated scales available to measure this. Design. It is an evaluative study. Methods. The data were collected using the Newcastle Satisfaction with Nursing Care Scale and by a demographic information questionnaire. After translinguistic study, the content validity of the scale was confirmed and tested on 200 patients who were recruited at Istanbul University Hospital on the day of discharge. Internal consistency of the scale was tested by Cronbach's alpha. Demographic variables related to the satisfaction scores were analysed using the Spearmen correlation, the Mann–Whitney U‐ and Kruskal–Wallis tests. Results. The Turkish version of the Satisfaction with Nursing Care Scale, with a total of 19 items, was determined to be suitable for measuring patient satisfaction with nursing care. Patients were generally satisfied with the nursing care received. The items with the most positive rating were respectively: the amount of freedom they were given on the ward, the amount of privacy they were given by nurses and how quickly nurses responded to their requests. The study found that female patients, older patients and those who had health insurance were the most satisfied. Conclusion. The Turkish version of the Satisfaction with Nursing Care Scale showed an adequate reliability and validity for its use on adult Turkish patients. Relevance to clinical practice. Nurses can use the Satisfaction with Nursing Care Scale of Newcastle Satisfaction with Nursing Scales in evaluating and improving the nursing care in clinical practice.     

Psychometric properties of the Chinese‐version Quality of Nursing Work Life Scale

In this study, we developed and tested the psychometric properties of the Chinese‐version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument‐development procedure with three phases was conducted in seven hospitals in 2010–2011. Phase I comprised translation and the cultural‐adaptation process, phase II comprised a pilot study, and phase III comprised a field‐testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese‐version Quality of Nursing Work Life Scale.     

Psychometric testing of the Chinese version of nursing practice environment scale

Aims. To test the reliability and validity of the Chinese version of the Nursing Practice Environment Scale (C‐NPES) translated from the Lake’s Practice Environment Scale of the Nursing Work Index and to explore nurses’ perceptions of the nursing work environments in Taiwan Background. Magnet hospitals are characterised by professional autonomy, control over nursing practice, adequacy of staffing, supportive management and effective interdisciplinary relationships, which are successful in attracting and retaining nurses. In Taiwan, this concept has gained importance since the SARS crisis of 2003. However, there have been limited Chinese instruments based on magnet hospital traits to explore Taiwan’s nursing work environment. Design. This study was designed as a cross‐sectional survey. Purposive convenience samples of 842 nurses were recruited from five acute hospitals in Taiwan. Internal consistency reliability, content validity using expert review, construct validity using factor analysis and criterion‐related validity were examined. Results. The Cronbach’s alphas were 0·90 for the total scale and 0·87–0·65 for the subscales. The validity was obtained using a content validity index and principal component analysis of five‐factor structure (variance explained 47·89%). The criterion‐related validity was supportive of the turnover rate (t = 7·84, p < 0·001). The participants disagreed on staffing and resource adequacy and participation in hospital affairs but agreed on professional development. Conclusion. The preliminary psychometric properties of C‐NPES have been established. Considering cultural appropriateness, the subscales of staffing and participation in hospital affairs need advanced modification. Relevance to clinical practice. The C‐NPES will provide hospital administrators with an overview of magnet hospital settings for nursing practice. It is beneficial for the stabilisation of the nursing workforce as well as for the optimisation of nursing work environments. Additionally, the use of professional development programs to enhance nurses’ knowledge of SARS prevention is favorable.     

Development of the nursing practice scale for end-of-life family conferences in critical care

ObjectivesThis study aimed to develop the Nursing Practice Scale for End-of-life Family conferences in critical care and to clarify the current status of nursing practice regarding family conferences.Research methodology/designWe conducted a cross-sectional, self-administered questionnaire survey with 955 critical care unit nurses in 97 hospitals. Content validity, factor validity and criterion-related validity, known-group validity, internal consistency and test–retest reliability were evaluated. Data were then analysed statistically.SettingAdult intensive care units or high dependency units in Japan.ResultsThree factors with 39 items were extracted through item analysis and confirmatory factor analysis as hypothesised (Factor 1: Preparation, Factor 2: Discussion and Factor 3: Follow-up), and the mean score per item for each factor was 3.57, 3.73 and 3.75, respectively. Nurses who had any certification or had worked in critical care unit for >5 years had a significantly greater score than the others. The Cronbach’s α were 0.86–0.96 and the intraclass correlation coefficients were 0.79–0.87.ConclusionThe Nursing Practice Scale for End-of-life Family conferences in critical care is a valid and reliable scale. This study could effectively facilitate communication among patients, their families and healthcare providers.     

Nurse Characteristics and Professional Autonomy

Relationships between selected demographic characteristics and professional nursing autonomy were examined. Identification of such relationships can strengthen development of the professional nursing role. Usable responses were returned by 542 RNs in a random sample of 2,000 nurses from four states. The Personal Attributes Questionnaire (Spence, Helmreich, & Stapp, 1974) and Nursing Activity Scale (Schutzenhofer, 1987) were used. Significant relationships were noted among autonomy and the following: nursing education, practice setting, clinical specialty, functional role, membership in professional organizations, and gender stereotyped personality traits.     

临床护士老年护理能力评价量表的编制及信效度检验

目的 编制临床护士老年护理能力评价量表并对其进行信效度检验。方法 将德国以技术为导向的老年护理行为能力评估模型作为理论框架,通过文献分析、德尔菲专家函询及小样本预试验形成量表初稿。选取2 067名护理人员进行预调查,其中500名护理人员的预调查数据用于项目分析,筛选量表条目,1 567名护理人员的预调查数据用于对正式版量表的信效度检验。结果 形成的临床护士老年护理能力评价量表包括3个一级条目,10个二级条目和43个三级条目。通过探索性因子分析提取3个公因子,累计方差贡献率为66.828%,总量表的Cronbach’s α系数为0.978,折半信度为0.902,重测信度为0.802,内容效度为0.980,验证性因子分析显示,该量表具有较好的结构效度。结论 临床护士老年护理能力评价量表具有良好的信效度,可作为评价我国临床护士老年护理能力的工具。     

Nurse’s perceptions of their group goal attainment capability and professional autonomy: a pilot study

Aim A pilot study to examine staff nurses’ perceptions of, and relationships between, group goal attainment capability and professional autonomy. Background A nursing group’s capability to employ appropriate nursing interventions leads to improvement in patient outcomes. Nurses’ goal attainment capability plays a role in achieving high-quality patient outcomes and may be related to professional autonomy. Method Staff nurses (N = 90) in one community hospital completed the Sieloff–King Assessment of Group Goal Attainment Capability within Organizations and the Nursing Activity Scale instrument. Results Staff nurses reported high goal attainment capability and high professional autonomy, and a positive significant but weak correlation (r = 0.24, P < 0.05) was found between nurses’ perceptions of group goal attainment capability and perceptions of professional autonomy. Three of the eight group goal attainment subscales were positively correlated with professional autonomy including: group leaders’ goal attainment capability competency, goals/outcomes competency and goal attainment capability perspective. Conclusion While three subscales of goal attainment capability were significant, the correlations were weak between professional autonomy and group leader’s goal attainment competency, goals/outcome competency and goal attainment perspective. Implications for Nursing Management Nurse managers can play a key role in nurses’ group goal attainment capability and perceived professional autonomy.     

某军队医院护士专业自主性现状及其影响因素调查

目的了解军队医院护士专业自主性现状及影响因素。方法以中文版护理实践量表为调查工具,对乌鲁木齐市某军队医院631名临床科室护士进行调查。结果该军队医院护士专业自主性得分为(173.53±19.27)分,处于中、高等水平;多元回归分析结果显示,职称和人员类别是影响军队医院护士专业自主性水平的主要因素(P0.01或P0.05)。结论管理者应关注专业自主性较低的人群,有针对性地采取措施提高护士整体的专业自主性水平,以提升护理质量。     

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.     

Practice and clinical decision-making autonomy among Hellenic critical care nurses

BACKGROUND: Nursing autonomy has been associated with better patient-outcomes; therefore, it is a priority for critical care nursing management. Low authority has been a persistent complaint of Hellenic intensive care unit nurses; however, issues of nursing autonomy have not been previously addressed empirically in Hellas. PURPOSE: To investigate: (1) the perceived contribution to clinical decision-making, (2) the degree of autonomy in technical tasks, and (3) factors related to practice autonomy in critical care nurses in Hellas. Additionally, because of the lack of sufficient tools, this study also aimed to construct and to validate a new tool for assessing practice and clinical decision-making autonomy among Hellenic intensive care unit nurses. MATERIALS AND METHODS: A Hellenic intensive care nursing autonomy scale, focused on technical aspects of care, was developed through literature review, a panel of experts and a pilot study in a random sample of 120 respondents. Items were refined by factor analysis, which revealed three major conceptual categories of autonomy: (1) basic technical, (2) advanced technical, and (3) clinical decision. Hellenic intensive care nursing autonomy (Likert 4, range: 38-152), was distributed to all nurses employed in intensive care units in Hellas (n = 807; attrition: 27%). Comparisons, correlation and multivariate regression were employed. RESULTS: The Hellenic intensive care nursing autonomy scale exhibited appropriate reliability (Cronbach's alpha = 0.86) and validity properties. Autonomy scores were moderate (mean: 105.24 +/- 9.58). Highest autonomy was attributed to basic technical tasks, followed by advanced technical tasks and decision-making. Male gender and higher education were predictors of higher overall, advanced technical and decision-making autonomy (P = 0.01). Bachelor degree graduates scored higher in decisional autonomy (P = 0.03). Intensive care unit experience and type of intensive care unit were also important determinants of decisional autonomy (P = 0.02). CONCLUSIONS: The results revealed moderate autonomy in technical tasks and low decisional autonomy among Hellenic intensive care unit nurses. Factors related to the educational preparation of nurses, gender issues and institutional characteristics might hinder intensive care unit nurses' autonomy in Hellas.     

Psychometric properties of the Caregiving Burden Scale for Family Caregivers with Relatives in Nursing Homes: Scale development

Aim: Most family caregivers continue their caregiving for frail relatives after admitting them to long‐term care facilities. The characteristics of this caregiving differ from those related to caregiving in home‐care settings. Thus, a new tool to evaluate the burden of family caregivers in institutional settings is needed. The aim of this study was to develop a new scale, the Caregiving Burden Scale for Family Caregivers with Relatives in Nursing Homes, and to confirm its validity and reliability. Methods: We conducted two cross‐sectional questionnaire surveys. The participants were a convenience sample of family members of residents in seven nursing homes for the validation study and in three nursing homes for the test‐retest study in Japan. Statistical analyses examined exploratory/confirmatory factor analyses, internal consistency, concurrent/discriminate validity, and test‐retest reliability. Results: A four‐factor solution with 16 items was selected as the most interpretable questionnaire. In the confirmatory factor analysis, the indices of fitness highly supported these results. The Cronbach's alpha coefficient for the total score was 0.86 and varied between 0.77 and 0.87 in the four domains. The scale showed moderate correlation with the Nursing Home Hassles Scale, suggesting its concurrent validity. The four domains had only a medium correlation with each other, indicating discriminate validity. Conclusions: The developed scale has acceptable validity and reliability for measuring the caregiving burden of family members with relatives in Japanese nursing homes. Future studies using the scale might lead to the improvement of care for family members with relatives in a long‐term care setting.     

Self-assessment of nursing competencies – validation of the Finnish NCS instrument with Italian nurses

Aim: Research focusing on competence assessment of practicing nurses has recently increased. However, few generic instruments are available for this purpose. This study reports cultural validation of the Italian version of the Nurse Competence Scale (NCS, English version) by exploring nurses’ perceptions of the use of the NCS instrument. Methods: Content validity of the Italian version of the NCS was assessed during the translation and back‐translation process. Thereafter, cultural validity was further explored by conducting self‐assessments and semi‐structured interviews with 10 nurses, who practise medicine, cardiology and intensive care wards. First, the Italian version of the 73‐item NCS was used to assess nurses’ competence levels and the frequency of using competencies in practice settings. Second, semi‐structured interviews were conducted to evaluate nurses’ perceptions of the use of the instrument. Results: The advanced beginners obtained a high overall competence level and the experienced nurses a very high overall competence level. These results are similar with the earlier findings of nurse competence levels with the NCS. The overall frequency of using NCS competencies in clinical practice indicated good cultural validity of the instrument. The instrument was considered easy to understand and to complete, and the Italian version was considered to express the domain of nursing. However, a need to make semantic specifications for some items for the Italian version was pointed out. Conclusions: This explorative pilot study reports a first phase cultural validation process. Carefully performed translation alone does not ensure validity of translated instrument. Interview method is recommended to deepen the understanding of concept in question and the content validity of the instrument. The results support previous research findings of the use of the NCS instrument and show that it could be very useful in competence assessment for Italian nurses.     

Development of a scale measuring the difficulties faced by nurses who care for patients with delirium in intensive care units

BackgroundDelirium in patients in the intensive care unit is associated with adverse outcomes. Nurses experience many difficulties in caring for those with delirium, which can lead to nurse burnout, prevent effective care for patients, and negatively impact the patient. The identification of factors creating challenges for nurses is, therefore, important to enable intervention.ObjectivesThe aim of this study was to develop a new scale to assess the difficulties faced by nurses caring for patients with delirium in the intensive care unit and to examine its reliability and validity.MethodsWe based our draft scale items on literature reviews and interviews. Four experts evaluated the collected items. After a pilot study, 211 nurses working in intensive care units in Japan completed the questionnaire. Subsequent statistical analysis of results included factor validity, construct validity, known-group validity, internal consistency, and test–retest reliability.ResultsExploratory factor analysis extracted a scale of 33 items with eight factors and an additional scale of four items with one factor. The analysis of construct validity suggested a possible association with the Strain of Care for Delirium Index. In the known-group validity, a comparison with two groups based on experience in the intensive care unit found significant differences among the five factors. Internal consistency (Cronbach's α = 0.68–.87) and test–retest reliability (intraclass correlation coefficients = .46–.62) were confirmed.ConclusionWe developed a difficulty scale for nurses caring for patients with delirium in the intensive care unit and confirmed its reliability and validity. The difficulty factors were developed with the intention to identify educational interventions for nurses and the introduction of new organisational resources, such as manpower and providing emotional support and feedback to nurses.     

The reliability and validity of the Chinese version of nurses’ self-concept questionnaire

cao x.y., Liu X.H., tian l. & guo y.q. (2013) Journal of Nursing Management  21 , 657–667 The reliability and validity of the Chinese version of nurses’ self-concept questionnaire Aim To examine the reliability and validity of the Chinese version of nurses’ self-concept questionnaire. Background Nurses’ self-concept is important to alleviate the current shortage of nurses. Nurses’ self-concept questionnaire is an effective instrument to measure nurses’ self-perception of professional competencies. However, the psychometric properties of the Chinese version have not been tested. Methods A two-stage research design was used in this study. At Stage 1347 registered nurses were recruited to establish the psychometric properties of the Chinese version. At Stage 2, a confirmatory factor analysis was used to examine the extracted factor structure from Stage 1 with 1017 respondents as a sample. Results The internal consistency of the Chinese version was 0.95 and the test–retest reliability was 0.83. The exploratory factor analysis extracted six dimensions. The findings at Stage 2 showed an acceptable model fit and discriminant validity. The Chinese version was a significant predictor of Maslach Burnout Inventory (β = −0.58; P = 0.00). Conclusions This study verified the psychometric properties of the Chinese version of nurses’ self-concept questionnaire. Implication for nursing management The Chinese version of nurses’ self-concept questionnaire will facilitate the evaluation of professional self-concept among nurses and help to develop the individualized self-concept strategies.     

妇女儿童医院护士职业价值观调查分析

目的调查妇女儿童医院护士职业价值观现状,为护理人力资源管理提供参考依据。方法采用护士职业价值观量表对某妇女儿童医院174名临床护士进行调查。结果妇女儿童医院护士职业价值观总均分为（3．38±0．45）分;其中得分较高的条目为保持所从事专业的实践／临床工作能力、保持患者对医护人员的信任、拒绝参与违背自己专业价值观伦理要求的护理工作;得分较低的条目为参加影响资源分配的公共决策、参与同事之间的评估活动和做患者的代言人,扮演患者倡导者的角色。结论护理管理者应经常组织科室团队活动,给予普通临床护士参与意见沟通的机会,发挥主观能动性,不断提高护士对职业价值观的认同。     

Self-efficacy of caring for patients in the intensive care unit with delirium: Development and validation of a scale for intensive care unit nurses

BackgroundImproving the self-efficacy of intensive care unit nurses for delirium care could help them adapt to the changing situation of delirium patients. Validated measures of nurses' self-efficacy of delirium care are lackingObjectivesThe objective of this study was to develop a Delirium Care Self-Efficacy Scale for assessing nurses' confidence about caring for patients in the intensive care unit and to examine the scale's psychometric properties.MethodsDraft scale items were generated from a review of relevant literature and face-to-face interviews with intensive care unit nurses; content validity was conducted with a panel of five experts in delirium. A group of nurses were recruited by convenience sampling from intensive care units (N = 299) for item analysis of the questionnaire, assessment of validity, and reliability of the scale. Nurse participants were recruited from nine adult critical care units affiliated with a hospital in Taiwan. Data were collected from August 2020 to July 2021.ResultsContent validity index was 0.98 for the initial 26 items, indicating good validity. The critical ratio for item discrimination was 14.47–19.29, and item-to-total correlations ranged from 0.67 to 0.81. Principal component analysis reduced items to 13 and extracted two factors, confidence in delirium assessment and confidence in delirium management, which explained 66.82% of the total variance. Cronbach's alpha for internal consistency was 0.94 with good test–retest reliability (r = 0.92). High scale scores among participants were significantly associated with age (≥40 years), work experience in an intensive care unit (≥10 years), delirium education, and willingness to use delirium assessment tools.ConclusionsThe newly developed Delirium Care Self-Efficacy Scale demonstrated acceptable reliability and validity as a measure of confidence for intensive care nurses caring for and managing patients with delirium in the intensive care unit.     

Psychometric properties of the Dutch version of the Attitude Towards Deliberate Self‐Harm Questionnaire

The attitude of nurses and treatment staff is crucial in the treatment of patients who self‐harm. However, many patients experience that attitude as negative. The aim of this study was to investigate the psychometric properties of the Dutch version of the Attitude Towards Deliberate Self‐Harm Questionnaire. A total of 261 questionnaires were used to measure validity and reliability. Sensitivity to change was measured using a post‐test measurement (n = 171) and a subgroup of 78 participants were given the questionnaire twice for test–retest measurement. Factor analysis revealed four factors explaining 33% of the variance. Cronbach's alpha values ranged 0.585–0.809, with 0.637 for the total scale. Intraclass correlation coefficient was assessed in order to estimate test–retest reliability, revealing the questionnaire was stable over time; the exception was factor 3, which had a value of 0.63. Sensitivity to change was found for the total score, factor one and two, and for three of the five items of factor three. We conclude that the Dutch version of the Attitude Towards Deliberate Self‐Harm Questionnaire possesses adequate psychometric properties and is potentially an acceptable instrument for measuring the attitude of nurses and health‐care staff towards patients who self‐harm in Dutch‐speaking countries.