Psychometric Testing of the Smoking Cessation Counseling Scale Among Magnet® Hospital Nurses

Abstract

Psychometrics of the Smoking Cessation Counseling scale, which measures adherence to evidencebased smoking cessation counseling practice, were originally estimated among rural hospital nurses.The purpose of this study was to estimate the scale's reliability, convergent validity, and factor structure among 289 nurses from 27 acute care Magnet® hospitals. The scale demonstrated acceptable estimates for internal consistency (Cronbach's alpha = .95, 95% CI= .94, .96).Convergent validity was supported by the association with comfort in conducting smoking cessation counseling (coefficient = 3.58, 95% CI = 2.80, 4.37) and shared vision (coefficient =.72, 95% CI = .02, 1.42). A four-factor structure (standard care, basic counseling, advanced counseling, and referral to services) was identified. The findings supported the scale's reliability and convergent validity among Magnet® hospital nurses. Further testing is needed to confirm the four-factor structure and accumulate psychometric evidence among different nursing providers and healthcare settings to expand the use of the instrument.

Multisite Studies Demonstrate Positive Relationship Between Practice Environments and Smoking Cessation Counseling Evidence‐Based Practices

“…The 24 items use a fourlevel Likert response (not at all, less than half the time, more than half the time, and all of the time) to measure the extent to which respondents perform each itemized practice. The SCC has demonstrated high internal consistency (α = .96) and validity (convergent validity with four factors in confirmatory factor analysis when tested with both of the samples used in this current study (Liu et al, 2017;Newhouse, Dennison Himmelfarb, et al, 2011). The four factors (or subscales) and their item examples are as follows: Standard Care (SCC-SSC, "I document my patient tobacco use"), Referal to Services (SCCSRS, "I provide the number for the toll-free National Quitline"), Basic Counseling (SCCSBC, "I advise tobacco users to quit"), and Advanced Counseling (SCCSAC, "I review past quit attempts-what helped, what led to relapse").…”

“…The SCCS primarily measures use of evidence-based smoking cessation counseling practice (Liu et al, 2017;Newhouse, Dennison Himmelfarb, et al, 2011). The 24 items use a fourlevel Likert response (not at all, less than half the time, more than half the time, and all of the time) to measure the extent to which respondents perform each itemized practice.…”

“…The Smoking Cessation Counseling Scale (SCCS) was developed based on evidence-based guidelines to assess how clinicians use the recommended practices (Newhouse, Dennison Himmelfarb, & Liang, 2011). Additional studies have validated adequate psychometric estimates for the SCCS (Lin, Johantgen, & Newhouse, 2017). Prior studies indicate that nurses' smoking cessation counseling activities are related to their confidence in conducting smoking cessation practices, not their personal characteristics (e.g., education, age, work status; .…”

“…Prior studies indicate that nurses’ smoking cessation counseling activities are related to their confidence in conducting smoking cessation practices, not their personal characteristics (e.g., education, age, work status; Newhouse, Dennison, et al., ). Standard care (assessing and documenting tobacco use) is reported most often, followed by basic counseling (e.g., advising users to quit), referral to services (e.g., providing the number for the toll free quit line), or advanced counseling (e.g., setting a quit date; Liu et al., ). Success in using evidence‐based smoking cessation practices requires more than an individual clinician's efforts.…”

“…In summary, guidelines focusing on smoking cessation counseling for people who use tobacco are not fully integrated into acute‐care nursing services (Liu et al., ; Newhouse, Dennison, et al., ; Newhouse, Dennison Himmelfarb, et al., ). The omission of smoking cessation counseling is a missed opportunity to improve health, and reduce mortality and morbidity for people who use tobacco.…”