Defensive Nursing Practices Scale: Development and Validation of a New Measurement Tool

Abstract

Objective: The aim of this study was to develop the Defensive Nursing Practices Scale (DNPS) and evaluate it psychometrically. Methods: The study had a methodological design and was reported in accordance with the STARD Checklist to ensure comprehensive and standardized reporting. Scale items were developed through the literature data. The data were collected from 1188 nurses between December 2023 and May 2024. The factor structure of the scale was established using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) with separate sample groups. Convergent and discriminant validity were assessed, and reliability was evaluated through Cronbach’s α values, adjusted item-total correlations, and composite reliability (CR). Results: The results of the EFA indicated that the DNPS consisted of 3 distinct sub-dimensions and included a total of 15 items, which collectively accounted for 58.2% of the total variance observed. This factor structure was further confirmed through a CFA, ensuring its robustness. Both convergent and discriminant validity were established, supporting the scale’s effectiveness in measuring the intended constructs. The overall Cronbach’s α coefficient for the scale was determined to be 0.906, indicating high internal consistency. The Cronbach’s α values for the individual sub-dimensions ranged from 0.758 to 0.887, reflecting acceptable reliability. Additionally, the CR values for the sub-dimensions fell between 0.814 and 0.893. Therefore, the DNPS was recognized as a valid and reliable tool for assessing the defensive practices employed by nurses. Conclusion: The DNPS was developed as a valid and reliable instrument for assessing defensive nursing behaviors. Additionally, it is a psychometrically robust tool that effectively evaluates nurses’ defensive practices, contributing to a deeper understanding of this phenomenon. © Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.