Development and psychometric testing of a new instrument to measure the caring behaviour of nurses in Italian acute care settings

Aim To develop and psychometrically test the Italian-language Nurse Caring Behaviours Scale, a short measure of nurse caring behaviour as perceived by inpatients. Background Patient perceptions of nurses’ caring behaviours are a predictor of care quality. Caring behaviours are culture-specific, but no measure of patient perceptions has previously been developed in Italy. Moreover, existing tools show unclear psychometric properties, are burdensome for respondents, or are not widely applicable. Design Instrument development and psychometric testing. Method Item generation included identifying and adapting items from existing measures of caring behaviours as perceived by patients. A pool of 28 items was evaluated for face validity. Content validity indexes were calculated for the resulting 15-item scale; acceptability and clarity was pilot tested with 50 patients. To assess construct validity, a sample of 2001 consecutive adult patients admitted to a hospital in 2014 completed the scale and was split into two groups. Reliability was evaluated using nonlinear Structural Equation Modeling coefficients. Measurement invariance was tested across sub-samples. Results Item 15 loaded poorly in the exploratory factor analysis (n=983) and was excluded from the final solution, positing a single latent variable with 14 indicators. This model fitted the data moderately. The confirmatory factor analysis (n=1018) returned similar results. Internal consistency was excellent in both sub-samples. Full scalar invariance was reached and no significant latent mean differences were detected across sub-samples. Conclusion The new instrument shows reasonable psychometric properties and is a promising short and widely applicable measure of inpatient perceptions of nurse caring behaviours. This article is protected by copyright. All rights reserved.