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 BehavioursScale, a short measure of nurse caring behaviour as perceived by inpatients.Background: Patient perceptions of nurses’ caring behaviours are a predictor ofcare quality. Caring behaviours are culture-specific, but no measure of patient perceptionshas previously been developed in Italy. Moreover, existing tools showunclear psychometric properties, are burdensome for respondents, or are not widelyapplicable.Design: Instrument development and psychometric testing.Method: Item generation included identifying and adapting items from existingmeasures of caring behaviours as perceived by patients. A pool of 28 items wasevaluated for face validity. Content validity indexes were calculated for the resulting15-item scale; acceptability and clarity were pilot tested with 50 patients. To assessconstruct validity, a sample of 2,001 consecutive adult patients admitted to a hospitalin 2014 completed the scale and was split into two groups. Reliability was evaluatedusing nonlinear structural equation modelling coefficients. Measurementinvariance was tested across subsamples.Results: Item 15 loaded poorly in the exploratory factor analysis (n = 983) and wasexcluded 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 subsamples. Fullscalar invariance was reached, and no significant latent mean differences weredetected across subsamples.Conclusion: The new instrument shows reasonable psychometric properties and is apromising short and widely applicable measure of inpatient perceptions of nurse caring behaviours.