Validation and Psychometric Evaluation of the Turkish Nursing Quality Improvement Attitude Scale.

OBJECTIVES

This study aimed to determine the validity and reliability of the Turkish version of the Nursing Quality Improvement Attitude Scale.

METHODS

A cross-sectional, multisite approach was used between April and November 2022 to collect data from 519 nurses across 4 distinct health care settings, including public and training-research hospitals located in a provincial center and 2 districts of the Black Sea Region, Turkey. Data were collected using a demographic information form and the Turkish version of QINASE. The original scale consists of 35 items, is unidimensional, and uses a 5-point Likert response scale. The original scale showed good psychometric properties, with a Cronbach alpha coefficient of 0.97. The QINASE was linguistically adapted using a forward-backward translation method and evaluated for content validity by experts, while its psychometric properties were assessed through Exploratory and Confirmatory Factor Analyses, along with Cronbach alpha and intraclass correlation coefficients for reliability.

RESULTS

Following the expert review, the scale's Content Validity Index (CVI) was determined to be 0.87. Based on the factor analysis results, 8 items were removed from the instrument to ensure structural integrity. Exploratory Factor Analysis (EFA) yielded a 27-item structure across 4 dimensions, which was further validated by Confirmatory Factor Analysis (CFA) and assessments of convergent and divergent validity. The identified factors were labeled as follows: 'Belief in Quality Improvement,' 'Institutional and Safety Culture,' 'Teamwork and Collaboration,' and 'Error Reporting.' No significant differences were observed between the test-retest mean scores of the scale or its sub-dimensions (P>0.05), while a strong, significant correlation was identified between the scores (P<0.001). Internal consistency analysis revealed a Cronbach alpha coefficient of 0.93 for the overall scale, with sub-dimension values ranging from 0.72 to 0.93. Finally, item-total correlation values ranged between 0.332 and 0.727, indicating that all items were significantly interrelated.

CONCLUSIONS

In this study, it was determined that the Turkish form of the scale is a valid and Reliable measurement tool for determining nurses' quality improvement attitudes.