Marla Weston examined antecedents of control over nursing practice using the IPNG participation subscale in this 2006 doctoral dissertation from the University of Arizona.
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
Background
This dissertation tested a hypothesized model of antecedents to control over nursing practice (CONP). Specifically, a formal structure for nurse participation in decision-making served as one of the hypothesized antecedent variables.
Study Design, Sample, and Instrument Use
The study used a nonexperimental, comparative design. Researchers collected data from 10 hospitals and 71 patient care units. In addition, psychometric testing of instruments at the individual level involved 994 staff nurse respondents who met eligibility criteria. For hypothesis model testing, the team aggregated data to analyze organizational and unit level contextual and variable effects related to CONP.
Because no available instruments measured structure alone, this study used Hess’ (1984, 1988) participation subscale of the Index of Professional Nursing Governance Scale (P-IPNG) to measure the organizing framework for CONP. Typically, researchers do not isolate or reorganize the subscale items from the originally designed subscales. However, in this study, the team measured this subscale in isolation.
Three different instruments measured the dependent variable of CONP: 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. Lower responses indicated participation and ability by management and administration, while higher responses indicated participation and ability by staff nurses. Cronbach’s alpha for this sample reached .89. Only the first item, asking about participation in unit committees for clinical practice, showed correlations of greater than .25 in fewer than 60% of the inter-item correlations. Although removing this item would have slightly increased the alpha, the researchers retained it for consistency with past uses of the instrument.
An exploratory factor analysis identified four factors within the participation subscale. Furthermore, confirmatory factor analysis demonstrated factor loadings between .46 to .77, with a moderate explained variance of 45%. As a result, the researchers judged the instrument 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 also showed support, with an overall rwg of .96 and individual unit rwgs of between .90 and .98. Moreover, reliability at the group level demonstrated an ICC of .70.
Results
At the organizational level, formal structure for CONP (measured by the P-IPNG) correlated significantly with all three measures of CONP.
Questions? Contact the author, Marla Weston.
References
Gerber RM, Murdaugh CL, Verran JA, Milton DA. (1990, September). Control over nursing practice scale: Psychometric analysis. Poster session presented at the National Conference on Instrumentation in Nursing, Tucson, AZ.
Havens DS, Vasey J. Measuring staff nurse decisional involvement: the decisional involvement scale. J Nursing Admin. 2003;33:331-336.
Hess RG Jr. The measurement of professional nursing governance. ProQuest Dissertations and Theses. 1994:55(05),1802. (AAT No. 9427545).
Hess RG Jr. Measuring nursing governance. Nurs Res. 1998;47:35-42.
Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2003;25:176-188.