Marla Weston, RN, PhD. Antecedents of Control over Nursing Practice. Doctoral dissertation (2006), University of Arizona; Tucson, AZ.
Report on Psychometrics of the Participation Subscale of the Index of Professional Nursing Governance Scale in Study on Antecedents of Control over Nursing Practice
Background
This dissertation study tested a hypothesized model of antecedents to control over nursing practice (CONP). A formal structure for nurse participation in decisions-making was hypothesized as one of the antecedent variables.
Study Design, Sample, and Instrument Use
The study used a nonexperimental, comparative design. Data were collected from 10 hospitals and 71 patient care units. Psychometric testing of instruments at the individual level was conducted with the 994 staff nurse respondents who met eligibility criteria. For hypothesis model testing, data were aggregated to provide an analysis of organizational and unit level contextual and variable effects related to CONP.
Because of the lack of available instruments measuring structure alone, for this study, Hess’ (1984, 1988) participating subscale of the Index of Professional Nursing Governance Scale (P-IPNG) was used to measure the organizing framework for CONP. Typically, when this instrument is used, the subscale items are not isolated or reorganized from the originally designed subscales. However, in this study, this subscale was measured in isolation.
The dependent variable of CONP was measured using three different instruments: the CONP Scale by Gerber et al., the nurse participation in hospital affairs subscale of the Revised Nursing Work Index (Lake, 2002), and the Decisional Involvement Scale (Havens, Vasey, 2003).
Instrument Psychometrics
The P-IPNG consisted of 12 items on a 5-point Likert-type scale with lower responses indicating participation and ability by management and administration and higher responses indicating participation and ability by staff nurses. Cronbach’s alpha for this sample was .89. Only the first item, asking about participation in unit committees for clinical practice, had correlations of greater than .25 in fewer than 60% of the inter-item correlations. Although removing this item from analysis would have slightly increased the alpha for the scale, the item was retained for consistency with past uses of the instrument.
Although an exploratory factor analysis resulted in four factors identified within the participation subscale, confirmatory factor analysis demonstrated factor loadings between .46 to .77, with a moderate explained variance of 45%. Thus, the instrument was judged to be a reliable and valid measure of the formal structure for CONP at the individual level in this sample. Construct validity at the group level was also supported with an overall rwg of .96 and individual unit rwgs of between .90 and .98. Reliability at the group level was demonstrated with an ICC of .70.
Results
At the organizational level, formal structure for CONP (measured by the P-IPNG) was significantly correlated with all three measures of CONP.
Questions? Contact the author, Marla Weston.
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