Development of Scale for Rating Nurse Under-Involvement with Patients and Evaluation of Its Reliability and Validitｙ

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  • 看護師版対患者Under-Involvement尺度の開発と信頼性・妥当性の検討
  • カンゴシバン タイ カンジャ Under Involvement シャクド ノ カイハツ ト シンライセイ ダトウセイ ノ ケントウ

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Background Little is known about what is an adequate emotional distance or too much emotional distance in the nurse-patient relationship. No scale to measure such a distance has been developed. This study calls maintaining too much distance in nurse-patient relationship "under-involvement" as opposed to "over-involvement" and defines it as "trying to have as little interest in the patient as possible in order to maintain a certain level of psychological distance and avoid building a close personal relationship." Objective　To develop a scale for measuring the level of under-involvement in a nurse-patient relationship and examine its reliability and validity. Methods Self-administered questionnaire composed of 25 questions on a proposed nurse under-involvement scale was distributed to 288 nurses working at a public hospital with over 400 beds in the Kansai area. Two hundred valid completed questionnaires, in which statistically inappropriate responses had been deleted, were used to perform a maximum-likelihood factor analysis employing maximum likelihood estimation and promax rotation. Findings　Three factors consisting of 10 elements were obtained for the under-involvement scale. Each factor was respectively named "non-selfdisclosure," "non-involvement, " and "fixed relationship." Cronbach's alpha for each factor was 0.77, 0.73 and 0.76 respectively (0.82 overall), indicating the reliability of these factors. The second factor (non-involvement) on the under-involvement scale and the overall scale showed a slightly negative correlation with the occupational commitment scale (r = - 0.31, p < 0.01 for the second factor; r = - 0.22, p < 0.01 for the overall scale), indicating the convergent validity of the under-involvement scale. While the second factor on the under-involvement scale demon strated a negative correlation with the occupational commitment scale, it had no correlation with either the job commitment scale or the organizational commitment scale (r = -0.17, p < 0.05 for job commitment; r = -0.15, p < 0.05 for organizational commitment), indicating the discriminant validity of the under-involvement scale. Conclusion　The study verified the reliability and validity of the scale for rating nurse under-involvement with patients. The scale is expected to be used for evaluating the efficacy of training programs designed to develop skills needed to manage nursing involvement.

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