Evaluation of psychometric properties of instruments measuring nursing‐sensitive outcomes: a systematic review

Abstract

Aim To evaluate the psychometric properties of instruments measuring Nursing‐sensitive Outcomes in acute care hospitals. Introduction Nursing‐sensitive outcomes have been shown to play an active role in the quality of care and cost‐effectiveness of health systems. Tools for assessing nursing‐sensitive outcomes are necessary to evaluate the nurses’ contributions to the health of patients. Methods Psychometric systematic review. The SCOPUS, PubMed, CINAHL, PsychoINFO, EMBASE, Science Direct and Web of Science databases were used. Searches were performed between March and May 2018. A search with screened titles and abstracts, assessment of methodological quality using the COSMIN checklist and risk of bias assessment using QUADAS‐2 were carried out. Results Twenty‐nine studies validated 26 different instruments. The methodological quality, measured with the COSMIN checklist, showed that the studies which assessed fewer psychometric properties had poorer quality. The majority of studies had high quality, and optimally assessed the risk of bias evaluated with QUADAS‐2. Discussion Concerning the focus of the scales, some of them focused on the patients while others focused on the nursing staff. The scales found assessed aspects such as nursing‐care quality, complexity and personalization. Conclusion The majority of studies had a high methodological strength and a thorough validation process. The Nurse Caring Behaviours Scale, the MISSCARE Survey, the Patient Advocacy Engagement Scale and the INICIARE scale were the tools which best combined structure, methodological quality and risk of bias. Implications for nursing and health policy The instruments with the best psychometric properties should be implemented in acute care settings to improve the quality of care, assess the effectiveness of nursing interventions, reduce health expenditure and reduce the occurrence of adverse events.

Validity of Nursing Outcomes Classification health promotion behavior scale in college students

“…The reliability analysis was verified in terms of the instrument's internal consistency, using Cronbach's alpha coefficient and item-total correlation, using the "Psych" statistical package (11) of R. Cronbach's alpha ranges from 0 to 1, where zero indicates the total absence of internal consistency of the items; and 1, 100% consistency. Thus, the acceptable alpha values are between 0.70 and 0.90, and item-total correlation values are acceptable when above 0.3, which are adopted for the study (12) .…”

“…Furthermore, although the NOC encourages studies on the reliability and validity of its scales, investigations of this scope on HPLP were not found in the health sciences databases. Thus, one of the biggest challenges in research involving results sensitive to nursing is related to the development and validity of appropriate instruments for its evaluation (12) .…”

Psychometric analysis of the comfort scale for family members of people in critical health condition

“…In this context, psychometry is one of the ways of taking measurements through tests that estimate constructs (also called latent variables), that is, characteristics of the individuals that cannot be observed directly (31) . According to The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), the properties of a psychometric instrument are structured on three pillars: reliability, validity and responsiveness of the instrument (32) .…”

Factors That Influence Nurse Staffing Levels in Acute Care Hospital Settings

“…In the past 40 years, instruments aimed at measuring the allocation of patients based on workload were based on tasks developed by nurses (Barrientos‐Trigo, Gil‐Garciía, Romero‐Sanchez, Badanta‐Romero, & Porcel‐Galvez, 2019). Intensive care units (ICUs) are where such instruments have been developed most extensively.…”

“…Within this context, the INICIARE (Inventario del NIvel de Cuidados mediante IndicAdoresde clasificacion de Resultados de Enfermerıa) scale is a relatively new instrument that measures patients' dependency levels and has demonstrated excellent values of reliability (α = 0.98) and validity (76.8% variance explained) for different acute care settings (Barrientos-Trigo et al, 2019). It is based on indicators of the Nursing Outcomes Classification, which is an international classification of sensitive nursing outcomes in the patient's condition and the efficacy of nurses (Moorhead, Johnson, Swanson, & Maas, 2018), grounded in Henderson's theory based on 14 activities of daily living believed to return patients to independence (Watkins, 1996).…”