Development of a scale to measure empowerment approaches of visiting nurses supporting mothers of school-aged children with autism spectrum disorder.

BACKGROUND

Autism spectrum disorder (ASD) is associated with substantial challenges for children and their families. Mothers of children with ASD may experience considerable parenting-related stress, particularly when they face difficulties in understanding and responding to their children's behavioral and communication characteristics. In home-visit nursing, empowerment-oriented approaches that support mothers' coping abilities and self-efficacy are important; however, a scale for assessing these support practices has not yet been sufficiently developed.

OBJECTIVE

This study aimed to conceptualize empowerment-oriented support practices for mothers of school-aged children with ASD in the context of home-visit nursing and to develop a corresponding measurement scale.

METHODS

This study was conducted in two phases. Preliminary scale items were generated through semi-structured interviews with home-visit nurses, followed by expert evaluation of content validity and a nationwide questionnaire survey. Exploratory factor analysis and examinations of the reliability and validity of the scale were subsequently conducted.

RESULTS

Exploratory factor analysis identified a three-factor structure comprising 14 items: (1) educational support to enhance mothers' sense of coping capability, (2) reframing support aimed at restoring confidence, and (3) partnership building through empathic engagement. The Kaiser-Meyer-Olkin value was 0.817, factor loadings ranged from 0.48 to 0.95, average variance extracted (AVE) ranged from 0.41 to 0.44, composite reliability (CR) ranged from 0.73 to 0.78, Cronbach's alpha was 0.874, and cumulative variance explained was 49.2%. The AVE values were below the recommended threshold of 0.50, indicating limited support for convergent validity. Discriminant validity was also not fully supported.

CONCLUSION

The scale developed in this study should be regarded as a preliminary measurement framework for organizing empowerment-oriented support practices provided by home-visit nurses to mothers of school-aged children with ASD, drawn from educational, cognitive, and relational perspectives. Given the limitations in convergent and discriminant validity, and the absence of confirmatory factor analysis using an independent sample, the scale should not currently be used for individual nurse evaluation, performance benchmarking, or quality assurance. Further psychometric validation using larger and more diverse samples, independent-sample confirmatory factor analysis, hypothesis testing with theoretically relevant external measures, and longitudinal studies is required.