护理领导者伦理决策信心量表的心理测量学评估。
Ethical decision-making confidence scale for nurse leaders: Psychometric evaluation.
机构信息
575981Chatham University School of Nursing, Pittsburgh, PA, USA.
Institute of Nursing Science and Practice, 31507Paracelsus Medical University Salzburg, Salzburg, Austria.
出版信息
Nurs Ethics. 2022 Jun;29(4):988-1002. doi: 10.1177/09697330211065847. Epub 2022 Mar 1.
BACKGROUND
Ethical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework.
AIMS
The objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale.
METHODS
The cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were used to develop the scale.
PARTICIPANTS
A convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position.
ETHICAL CONSIDERATIONS
Ethical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent.
RESULTS
The scale's item structure dimensionality and subscale's reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe.
DISCUSSION
This exploratory study is the first of its kind to focus on nurse leaders' confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales' psychometric properties.
CONCLUSION
This newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups.
背景
伦理决策信心源自临床专业知识，是护理领导者的核心能力。目前尚无工具可基于伦理决策框架来衡量护理领导者的信心水平。
目的
本研究旨在通过开发和测试新构建的伦理决策信心（EDMC）量表，比较美国和三个德语国家的护理领导者的伦理决策。
方法
该横断面调查包括 18 个关于伦理决策信心的理论衍生问题，用于开发该量表。
参与者
来自美国和三个德语国家的具有领导职位的护理领导者的便利样本。
伦理考虑
美国一所大学的 IRB 委员会给予了伦理批准。参与调查意味着自愿同意。
结果
对来自四个国家的护理领导者进行了量表项目结构维度和子量表信度的分析和比较。主成分分析（PCA）产生了一个 15 项双维度 EDMC 量表，得出一个与技能相关（9 项）和与行为相关（6 项）的信心维度。EDMC 子量表表现出良好到优秀的内部一致性。在两个子量表中，美国护理领导者对其 EDMC 平均得分的评价均高于欧洲的德语国家同行。
讨论
这是第一项关注国际背景下护理领导者在伦理决策方面信心的探索性研究。确定了一个总体因素结构，该结构由两个护理领导者样本共享，用于检验（子）量表的心理测量特性。
结论
新开发的量表是衡量护理领导者伦理决策信心的有效工具。该研究的有希望的结果应予以复制，以确保 EDMC 量表衡量与技能和行为相关的概念的有效性和可靠性，并包括来自各种文化、社会和人口统计学群体的护理领导者。
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