Psychometric testing of the revised "Families' Importance in Nursing Care-Nurses' Attitudes instrument"

Abstract

Background

The validity of instruments is crucial in ensuring that data collected are sound and that these data represent what the instrument claims to measure. When an instrument is revised or used in a different population, it is useful to re-examine its construct validity. Aim

To test the psychometrics properties of an instrument—the revised Families’ Importance In Nursing Care—Nurses’ Attitudes, designed to measure nurse’ attitudes towards involving family in nursing care in an adult acute care setting. Design and methodology

A cross-sectional survey design was used in April–May 2016 with a sample of Enrolled and Registered Nurses (N = 212) to test the factor structure of the revised Families’ Importance In Nursing-Nurses’ Attitudes instrument. The instrument had 26 items with a five-point Likert response scale. Principle components analysis and exploratory factor analysis were performed with oblique rotations to assess the internal structure of the instrument. Setting

A regional referral hospital in Queensland, Australia. Results

Using Principal Components Analysis and Principal Axis Factoring, we obtained the same factor structure to that originally identified for the instrument. Our results suggested the removal of six items to refine the instrument and achieve simple structure. Conclusion

The removal of several items, relabeling of factors and residual cross-loading issues suggest that further revisions to the instrument are needed. Why is this research or review needed?

Family involvement in patient care may improve quality and the attitudes nurses hold may either help or hinder family involvement. The revised Families’ Importance in Nursing Care—Nurses’ Attitudes instrument is most widely used in Europe to measure nurses’ attitudes about the importance of involving families in nursing care. A key validity issue in new and revised scales is the replication of the hypothesized factor structure using a new sample. What are the key findings?

Factor analysis of the revised Families’ Importance in Nursing Care—Nurses’ Attitudes instrument suggests item refinement is still needed. Our data resulted in the removal of six items to achieve a four-factor structure represented by 20 items. How should these findings be used to influence policy/practice/research/education?

This paper shows the importance of a systematic and evidence-based approach to determining the construct validity of new and refined scales. Following further evaluation, this instrument may prove suitable to measure specific interventions that are targeted at changing nurses’ attitudes to promote family-centred practices in hospitals.