Developing a Patient Advocacy Scale for Nurses

• Published in: European journal of public health Vol. 29; no. Supplement_4
• Main Authors: Sermet, E, Kadioglu, H
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.11.2019; Oxford Publishing Limited (England)
• Subjects: Advocacy; Correlation analysis; Eigenvalues; Evaluation; Exploratory factor analysis; Factor analysis; Indexes; Nurses; Patients; Public health; Reliability; Reliability analysis; Reliability aspects; Validity
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz186.337

Abstract Background Patients can sometimes become defenseless. Patient advocacy is one of the most important roles of nurses in healthcare. No valid and reliable instrument that evaluates nurses’ behavior as patient advocates has been encountered in the literature. The purpose of this study was to develop a patient advocacy scale for nurses. Methods This methodological study was conducted in Istanbul over the period October - December 2018 with 500 nurses. Initially, a scale of 57 items was devised after discussions with 14 academic and clinical nurses. The scale was tested for content validity using the Content Validity Index and for construct validity with Exploratory Factor Analysis, after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha. Results Content validity index for the scale was found to be .97. The first factor analysis resulted in a 10-factor construct, where the eigenvalue for the scale was greater than 1 and the construct explained 63.43% of total variance. At the end of the factor analysis, items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated 18 times. In the last factor analysis of the 39-item scale, a 7-factor construct was found with an eigenvalue greater than 1 that explained 61.3% of total variance. The scale’s item-total correlations ranged between .42 - .75 and Cronbach’s coefficient alpha was calculated to be .95. Conclusions The newly developed instrument was found to be valid and reliable. The scale can be used to assess the patient advocacy behavior of nurses working in Turkey. Its intercultural adaptation for use with nurses working in other countries is recommended. Key messages The Patient Advocacy Scale for Nurses has been found to be valid and reliable. It can be used to assess nurses’ patient advocacy behavior.