Ethical decision-making confidence scale for nurse leaders: Psychometric evaluation

BackgroundEthical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework.AimsThe objective of this research was to compare ethical decision-ma...

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Bibliographic Details
Main Author: Birkholz, Lorri (Author)
Contributors: Kutschar, Patrick ; Kundt, Firuzan Sari ; Beil-Hildebrand, Margitta
Format: Electronic Article
Language:English
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Interlibrary Loan:Interlibrary Loan for the Fachinformationsdienste (Specialized Information Services in Germany)
Published: 2022
In: Nursing ethics
Year: 2022, Volume: 29, Issue: 4, Pages: 988-1002
Further subjects:B Moral Sensitivity
B ethical climate of organizations / moral
B management / ethics and leadership
B Moral Distress
B Professional Ethics
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Summary:BackgroundEthical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework.AimsThe objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale.MethodsThe cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were used to develop the scale.ParticipantsA convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position.Ethical ConsiderationsEthical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent.ResultsThe scale’s item structure dimensionality and subscale’s reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe.DiscussionThis exploratory study is the first of its kind to focus on nurse leaders’ confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales’ psychometric properties.ConclusionThis newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups.
ISSN:1477-0989
Contains:Enthalten in: Nursing ethics
Persistent identifiers:DOI: 10.1177/09697330211065847