The Leuven questionnaire for Patient Self-care during Chemotherapy (L-PaSC): Instrument development and psychometric evaluation

PurposeSince chemotherapy has largely become an outpatient treatment, adequate self-management is of great importance. Available instruments focus exclusively on dealing with side effects. However, self-care during chemotherapy not only concerns symptom self-management. The aim of this study was to develop a valid instrument to assess patient self-care during chemotherapy.MethodFirst, we developed a topic list for our construct by performing a theory and literature review. Second, an expert panel of nine oncologists and oncology nurses evaluated content validity of the developing construct and its items using a triple Delphi procedure. A preliminary psychometric evaluation in 144 patients allowed identification and correction of items with poor psychometric properties. A convenience sample of 448 patients was used to evaluate item statistics (item difficulty), reliability (Cronbach alpha) and construct validity (exploratory factor analysis) of the final instrument.ResultsWe developed a 22-item instrument with 7 themes expressing the most relevant aspects of patient self-care during chemotherapy. Seven items cover symptom self-management, while 15 items reflect other aspects of self-care during chemotherapy. Content validity was excellent (CVI = 0.78–1.00). Item difficulty index of the questions ranged from 0.17 to 0.89. Internal consistency is acceptable (Cronbach alpha = 0.76). Exploratory factor analysis defines two underlying factors: adhering to treatment recommendations and managing treatment-related negative events on the one hand, and relieving symptoms on the other hand.ConclusionsThe L-PaSC demonstrated good content validity and psychometric properties. The L-PaSC can be applied in research and clinical practice for evaluating patient self-care during chemotherapy.     

Psychometric evaluation of undergraduate student nurses' learning perceived needs in disaster nursing: Two cross-sectional studies

BackgroundDisaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation.ObjectivesTo adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing.Design, settings and participantsTwo cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019.MethodsThe instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability.ResultsThe exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87.ConclusionThe Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.     

Modification and Initial Psychometric Evaluation of the Physical Health Attitude Scale for Use in the Canadian Mental Health and Addictions Context

Introduction: The Physical Health Attitude Scale (PHASe) tool was developed to better understand mental health nurses’ attitudes towards their involvement and confidence in physical health care. This tool has been used in the United Kingdom and Australia; however, it has not been used in Canada.

Aim: This study aims to modify and provide an initial psychometric evaluation of the PHASe tool for use in a Canadian mental health and addictions context.

Methods: In Phase 1, clinical experts (n?=?8) were consulted to provide feedback on the content and face validity of the PHASe tool. In Phase 2, the PHASe tool was piloted with nurses at a large urban mental health and addiction organization in Ontario, Canada (n?=?77).

Results: In Phase 1, 4 items were added and 5 items were removed from the tool based on feedback provided by experts. In Phase 2, 12 poorly correlated items were removed. A two-factor solution was identified, with subscales “confidence” and “barriers and attitudes”.

Discussion: Initial psychometric evaluation suggests that a revised 15-item version of the PHASe tool is valid and reliable in a Canadian mental health and addictions context; however, more testing is recommended in larger, more diverse samples.     

The Chinese Version of the Work Control Scale for Nurses: Modifying the Translation and Psychometric Testing

PurposeThe aim of the study was to modify and test the psychometric properties of the Chinese version of the work control scale (C-WCS).MethodsThe translated scale was administered to 840 nurses in Shanghai. Validity was assessed in terms of content validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency and test–retest reliability were estimated using Cronbach α and the intraclass correlation coefficient.ResultsPsychometric analyses of the C-WCS indicate high reliability and good content and construct validity.ConclusionThe C-WCS has good psychometric properties and can be used as a valid tool for measuring work control among nurses in China. The C-WCS will help to further explore the correlations between perceived work control and organizational quality indicators such as nurses' satisfaction, job stress, well-being, or intention to stay. It can also be used in nursing outcome studies of work control strategies.     

Psychometric Properties of the Knowledge,Attitude, and Practice Behavior of Oncology Nurses on Advance Care Planning Instrument

ObjectiveAdvance care planning has been practiced in Western countries for several years, but non-Western cultures face challenges in implementation. This study was dedicated to translating the instrument measure into Chinese, examining its psychometric qualities and exploring the relationships among knowledge, attitudes, and practicing behaviors in advance care planning among oncology nurses in China.Data SourcesThe research adopted a cross-sectional design from September 3 to October 5, 2021. After translation and cultural adaptation, oncology nurses (N = 249) were involved. The research used psychometric evaluation to verify that the content validity, structural validity, internal consistency, and test-retest reliability enhanced the analytical rigorous instrument.ConclusionThe translated and adapted instruments showed reasonable psychometric properties. The Chinese version of the KAB-ACP for oncology nurses is a consistent, valid, and reliable instrument for assessing knowledge, attitude, and practice behavior of Chinese-speaking nurses who work in advance care planning by researchers or clinicians.Implications for Nursing PracticeMeasures of oncology nurses’ knowledge, attitudes, and practice behaviors will allow for more targeted interventions that will improve end-of-life care outcomes.     

Usefulness,feasibility and face validity of the interRAI Palliative Care instrument according to care professionals in nursing homes: A qualitative study

BackgroundNursing homes are important locations for palliative care. High quality palliative care requires an evaluation of the different care needs of the nursing home residents. The interRAI Palliative Care instrument is a comprehensive assessment that evaluates the needs and preferences of adults receiving palliative care.ObjectivesThis study aims to evaluate the usefulness, feasibility and face validity of the interRAI Palliative Care instrument.DesignA qualitative study was conducted, based on the abductive reasoning approach.SettingFifteen nursing homes in Flanders (Belgium).ParticipantsCalls for participation were sent out by four umbrella organizations of Flemish nursing homes (Belgium) and at a national conference for nursing home staff. Nineteen care professionals (nurses, certified nursing assistants, psychologists, physiotherapists, quality coordinators and directors) of 15 nursing homes voluntarily agreed to participate in the study.MethodsDuring one year, care professionals evaluated the needs and preferences of all nursing home residents receiving palliative care by means of the interRAI Palliative Care instrument. Data on the usefulness, feasibility and face validity of the interRAI Palliative Care instrument were derived from notes, semi-structured interviews and focus groups with participating care professionals and were thematically analyzed and synthesized. Data were gathered between December 2013 and March 2015.ResultsIn general, the interRAI Palliative Care (interRAI PC instrument) is a useful instrument according to care professionals in nursing homes. However, care professionals made a series of recommendations in order to optimize the usefulness of the instrument. The interRAI PC instrument is not always feasible to complete because of organizational reasons. Furthermore, the face validity of the instrument could be improved since certain items are incomplete, lacking, redundant or too complex.ConclusionsFindings highlight the importance of adapting the content of the interRAI Palliative Care instrument for use in nursing homes. Furthermore, the use of the instrument should be integrated in the organization of daily care routines in the nursing homes. Tackling the critical remarks of care professionals will help to optimize the interRAI Palliative Care instrument and hence support palliative care of high quality in nursing homes.     

The Leuven Questionnaire on Patient Knowledge of Chemotherapy (L-PaKC): Instrument development and psychometric evaluation

PurposeEvidence suggests that patients who gain knowledge perform better self-care, cope better and are more satisfied. Today, up-to-date and valid instruments for evaluating patient knowledge on chemotherapy are unavailable. Hence, our aim was to develop a valid instrument to assess patients' knowledge on chemotherapy.MethodWe performed a literature review to develop a topic list for the construct. Using a triple Delphi procedure, an expert panel of nine oncologists and oncology nurses evaluated the face and content validity of the topic list and the generated items. A preliminary psychometric evaluation of 144 patients allowed to identify and remediate items having limited applicability and item validity. A convenience sample of 440 patients was used to evaluate item statistics (item difficulty), reliability (Cronbach alpha) and construct validity (exploratory factor analysis) of the final instrument.ResultsWe developed a 20-item instrument reflecting 14 relevant themes of patient knowledge on chemotherapy in 13 questions. Twelve items cover general chemotherapy aspects, eight items cover treatment-specific knowledge. Three questions are facultative and address oral chemotherapy. Content validity was excellent (CVI = 0.78–1.00). Item difficulty ranged from 0.25 to 0.95. Internal consistency was acceptable (Cronbach's alpha = 0.67). Exploratory factor analysis defined four underlying factors: general aspects of chemotherapy treatment, negative treatment-related events, information resources and intake of oral chemotherapy.ConclusionsThe Leuven Questionnaire on Patient Knowledge of Chemotherapy (L-PaKC) demonstrated good content validity and psychometric properties, permitting application in both research and practice for evaluating patient knowledge on chemotherapy.     

Development and psychometric evaluation of the Hospital Nurse Interpersonal Empathy Questionnaire

ObjectiveThis study aimed to develop the Hospital Nurse Interpersonal Empathy Questionnaire (HNIEQ) and evaluate its psychometric properties.MethodsThe primary version of HNIEQ was deductively developed through reviewing the literature, and then, its face and content validity were assessed. For construct validity assessment, 250 hospital nurses were randomly selected from hospitals of Kashan, Iran. Their data were used for exploratory factor analysis. Internal consistency was assessed through Cronbach’s α coefficient and questionnaire stability was assessed through test-retest intraclass correlation coefficient. Ceiling and floor effects were also assessed. Data analysis was done via the SPSS program (v. 16.0).ResultsThe final version of HNIEQ contained 45 items. Exploratory factor analysis revealed a six-factor structure (empathetic and ethical attention, perspective adoption, emotional affectability, altruism, emotion identification and responsivity, and reflection forecasting) for the questionnaire which explained 52.7% of the total variance of its total score. The Cronbach’s α coefficient and the intraclass correlation coefficient of HNIEQ were 0.953 and 0.972, respectively.ConclusionHNIEQ is a valid and reliable instrument for empathy assessment among 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.     

Development and Psychometric Testing of a Tool Measuring Nurses’ Competence for Disaster Response

IntroductionThere is a growing awareness among governments, communities, and health care agencies of the need to evaluate roles and competencies in disaster nursing. A validated instrument was developed to evaluate nurses’ competencies for disaster response.MethodsA psychometric evaluation study was developed in 2 stages: 1) content and face validity, and 2) verification of feasibility and reliability with test-retest. Competencies were extracted from the Framework of Disaster Nursing Competencies published by the International Council of Nurses. The participants included 8 experts in emergencies and disasters who were nurses with a PhD and had more than 2 years of experience with education or clinical practice in emergencies or disasters, and 326 nurses from a mobile emergency care service in southern Brazil. The data analysis used a content validity index and intraclass correlation coefficients. The psychometric properties of the instrument included reliability assessed with Cronbach alpha, feasibility and test-retest reliability assessed with t tests and intraclass correlation coefficients, and factor analysis.ResultsThe overall evaluation of the instrument yielded an intraclass correlation coefficient of 0.92 (SD = 0.04), and the mean content validity index was acceptable at 0.88 (SD = 0.12). Out of 51 items, 41 were validated and organized in 3 domains according to factor analysis: 1) care of the community; 2) care of the individual and family; and 3) psychological support and care of vulnerable populations. The instrument demonstrated good internal consistency (Cronbach α = 0.96) and adequate test-retest reliability (intraclass correlation coefficient >0.7).DiscussionThe Nurses’ Disaster Response Competencies Assessment Questionnaire showed good internal consistency, adequate reproducibility, and appropriate feasibility for use to evaluate nurses’ competencies for disaster response.     

Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care

ContextThe European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL) is a shortened version of the EORTC QLQ-C30, developed for use in advanced cancer patients.ObjectivesWe evaluated the psychometric properties of the Korean version of the EORTC QLQ-C15-PAL to determine if this tool can be used to evaluate Korean patients with cancer who receive palliative care.MethodsA multicenter, cross-sectional survey was performed in palliative care units and hospices in Korea from September to October 2009. A total of 102 patients with cancer completed the questionnaires that included the EORTC QLQ-C15-PAL.ResultsThe compliance rate was high, with the missing rate for each item ranging from 0% to 7.8% (mean 3.1%). A multitrait scaling analysis revealed good convergent and discriminant validity, with only three scaling errors. The Cronbach’s alpha coefficients ranged from 0.65 to 0.89. The questionnaire discriminated among patient subgroups with different clinical profiles (e.g., performance status and degree of oral intake), thereby demonstrating the clinical validity of this tool.ConclusionOur findings indicate that the Korean version of the EORTC QLQ-C15-PAL is a reliable and valid instrument with regard to its psychometric properties. This tool is suitable for measuring quality of life, particularly with regard to physical aspects, in Korean cancer patients who receive palliative care.     

Initial validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale: Study of Portuguese end-of-life cancer patients

BackgroundThe Mini-Mental Adjustment to Cancer Scale (Mini-MAC) is a 29-item instrument designed to evaluate the responses developed by cancer patients during their mental adjustment to diagnosis and treatment.Purpose of the researchThis study aims to validate the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) translated and adapted to the Portuguese language and culture, in end-of-life cancer patients receiving palliative care.Methods and designThe instrument was administered to 346 Portuguese end-of-life cancer patients, receiving care through outpatient visits or admitted into palliative care units, without cognitive symptoms and with symptoms under control. A cross-sectional validation study using orthogonal rotation through the varimax method followed by convergent and discriminant validity.Key resultsThe analysis of the main components confirms the existence of five factors, demonstrating the validity of the construct, with good internal consistency in the subscales and Cronbach's alpha values between 0.78 and 0.93. Good test-retest reliability was also found, and r values for subscales ranged from 0.62 to 0.99.ConclusionsThe instrument proved to be a reliable, valid and sensitive measure in the study of mental adjustment of Portuguese end-of-life patients with cancer receiving palliative care.Relevance to practiceNurses can use the Mini-MAC Scale in research and clinical practice in order to evaluate the mental adjustment of Portuguese end-of-life cancer patients receiving palliative care.     

Development and Validation of an Instrument for Measuring Parenting Stress among Clinical Nurses

PurposeClinical nurses who are mothers of preschool-aged children experience extreme parenting stress linked to their hospital work environment and shift work, differing from that generally experienced by mothers. This study aimed to develop and validate a parenting stress scale that considers the clinical nurses’ form of work and its characteristics.MethodsThe scale items were initially derived from in-depth interviews and a literature review and were revised and modified based on the results of content validity testing by experts. The developed instrument was evaluated using data from 157 clinical nurses in South Korea who were mothers of preschool-aged children.ResultsIn the instrument validation stage, 19 items categorized in four factors (psychological burden, physical and mental fatigue, work shift, and work environment) were derived from construct validity, and the cumulative explanatory power was 56.6%. Furthermore, the convergent and discriminant validity and external construct were confirmed. Cronbach’s α of the final instrument was .86 (range: .81–.86). The validity and reliability of the newly developed parenting stress scale for clinical nurses were established in this study; it uses a 4-point Likert scale. A higher mean score by factor indicates a higher level of parenting stress experienced by clinical nurses.ConclusionThis instrument would be beneficial to measure the level of parenting stress among nurses who work in hospitals and evaluate factors related to their parenting stress to devise effective interventions.     

Capturing interprofessional collaboration between physicians and nurses in an acute care setting. A validation study of the revised German version of the Collaborative Practice Scales

ABSTRACT

The relevance of interprofessional collaboration (IPC) is widely acknowledged. Given the lack of a fully validated instrument in the German language for measuring the level of IPC, we built upon the current, albeit psychometrically weak, German-language version of the instrument to devise a new version with improved wording and for subsequent psychometric testing. In a tertiary hospital in German-speaking Switzerland, 160 physicians and 374 nurses completed the revised Collaborative Practice Scales in German (CPS-G) and additional scales regarding positive and negative activation at work and regarding job demands and job resources. A confirmatory factor analysis of the CPS-G was performed, and internal consistency estimates were computed. Partial correlations between the CPS-G and the additional scales were examined for criterion validity. The model fit of the CPS-G was good for physicians (χ²/df = 2.38, p?<?.001; CFI = .923; RMSEA = .051, 90%-CI (0.037–0.065)) and moderate for nurses (χ²/df = 5, p?<?.001; CFI = .919; RMSEA = .087, 90%-CI (0.072–0.102)) supporting the two-factor structure of the original English version. Reliability was acceptable in all sub-scales for physicians (inclusion, α = 0.79; consensus, α = 0.80) and nurses (assertiveness, α = 0.77; understanding α = 0.82). As expected, the CPS-G physicians’ subscales correlated positively with positive activation and job resources and negatively with negative activation and job demands, albeit not always statistically significantly. Similar correlations were found with the CPS-G nurses’ subscales other than in one instance. The CPS-G showed good construct and criterion validity and acceptable internal consistency. It consequently represents a valid instrument ready for application to measure the level of interprofessional collaboration between nurses and physicians in acute care settings.     

Benefit finding in adult cancer populations: Psychometric properties and performance of existing instruments

PurposeTo analyse the psychometric properties and performance of existing instruments that aim to measure benefit finding in adult cancer populations.MethodsFour electronic databases were searched. The focus was to identify English language, peer-reviewed journal articles where benefit finding is assessed with adult cancer populations. The terms ‘benefit finding’, ‘cancer’, ‘instruments’, ‘scales’, and ‘adult’ were used in various combinations. The instruments were rated against established criteria for instrument construction, reliability, validity, and interpretability.ResultsSeventeen benefit finding instruments were reviewed. The instruments present a multifarious conceptualisation of the construct. Instrument structure is diverse. Several instruments (n = 4) reported on all the psychometric properties, but not interpretability. One instrument, the Stress-Related Growth Scale – Revised, additionally reported correlation statistics with another benefit finding instrument. Based on the information provided, the psychometric rigour of a number of instruments is yet to be established.ConclusionsOne instrument reported validation statistics for all the identified criteria. While existing instruments provide a range of operationalisations of the benefit finding concept and have been more or less used in previous research, a majority are in the early stages of development and require further validation work in adult cancer populations. Given the increasing interest in the role benefit finding in clinical practice, researchers are urged to use these instruments further and to report relevant validation statistics when using them.     

A pilot study exploring the relationship between self-compassion,self-judgement,self-kindness,compassion, professional quality of life and wellbeing among UK community nurses

BackgroundCompassion fatigue and burnout can impact on performance of nurses. This paper explores the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life, and wellbeing among community nurses.AimTo measure associations between self-compassion, compassion fatigue, wellbeing, and burnout in community nurses.MethodQuantitative data were collected using standardised psychometric questionnaires: (1) Professional Quality of Life Scale; (2) Self-Compassion Scale; (3) short Warwick Edinburgh Mental Wellbeing Scale; (4) Compassion For Others Scale, used to measure relationships between self-compassion, compassion fatigue, wellbeing, and burnout.ParticipantsA cross sectional sample of registered community nurses (n = 37) studying for a postgraduate diploma at a University in the North of England took part in this study.ResultsResults show that community nurses who score high on measures of self-compassion and wellbeing, also report less burnout. Greater compassion satisfaction was also positively associated with compassion for others, and wellbeing, whilst also being negatively correlated with burnout.ConclusionHigh levels of self-compassion were linked with lower levels of burnout. Furthermore when community nurses have greater compassion satisfaction they also report more compassion for others, increased wellbeing, and less burnout. The implications of this are discussed alongside suggestions for the promotion of greater compassion.     

Neonatal nurses’ professional quality of life: An integrative review

BackgroundNurses working in critical care environments, such as intensive care units, are susceptible to impaired professional quality of life. Those caring for babies and children, even more so.AimTo appraise the extant literature regarding neonatal nurses’ professional quality of life and propose recommendations for neonatal nursing practice, policy, and research.MethodThis integrative review aligns with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and Whittemore and Knafl's five-stage methodology. A systematic search of the CINAHL, Medline, and PsychInfo electronic databases and grey literature was conducted. Peer reviewed articles referring to neonatal nurses’ work-related stressors and satisfiers which had been published in English language between 1990 and 2020 were included.FindingsNeonatal nurses of varying ages, experience levels and cultures, report burnout, secondary and post-traumatic stress; however, the cumulative impacts result in higher prevalence among experienced clinicians. Compassion fatigue is mitigated by compassion satisfaction.DiscussionNeonatal nurses’ report lower resilience and higher emotional exhaustion and sensitivity to organisational change than their medical colleagues. Despite workplace adjustments some nurses may remain disproportionately at risk due to factors associated with their personality traits, affect, and practice environments.ConclusionFurther research exploring the relationships between structural factors impacting neonatal nurses’ professional quality of life and organisational outcomes is required. The generalisability of future studies will be enhanced by longitudinal design, recruitment of heterogeneous samples, and use of scales with psychometric adequacy to capture complex interrelationships between variables.