Psychometric testing of the Indonesian version of the Nurses’ Ethical Behavior in Protecting Patients’ Rights (I-NEBPPR) scale
PDF
XML

Keywords

nurses
patient rights
ethical behavior
psychometric properties
factor analysis
Indonesia
validity
reliability

How to Cite

Susmairni, D., Ninh, D. T., Li, C., & Lee, G. (2023). Psychometric testing of the Indonesian version of the Nurses’ Ethical Behavior in Protecting Patients’ Rights (I-NEBPPR) scale. Belitung Nursing Journal, 9(6), 627–633. https://doi.org/10.33546/bnj.2921
Crossref
Scopus
Google Scholar

Link to Google Scholar

Accepted for publication: 2023-10-24
Peer reviewed: Yes

Related articles in


Search Relations - Article by Author(s)

Share this article on:

Abstract

Background: Nurses routinely encounter ethical dilemmas with patients and healthcare professionals. Therefore, it is crucial for them to be conscious of ethical principles and apply them in their decision-making processes. However, no specific questionnaire is available to assess nurses’ ethical conduct in Indonesia.

Objective: This study aimed to assess the psychometric properties of the Indonesian version of the Nurses’ Ethical Behavior in Protecting Patients’ Rights (I-NEBPPR) scale.

Methods: Following the World Health Organization’s guidelines and utilizing the WHODAS 2.0 translation package, the NEBPPR was translated into Bahasa Indonesia and underwent a rigorous translation and adaptation process. Data were collected between October and November 2022 and included 283 Indonesian nurses as participants. Confirmatory factor analysis (CFA) was used to evaluate construct validity. Convergent validity, discriminant validity, and reliability were also performed for comprehensive evaluation. IBM SPSS statistics version 27.0 and AMOS 24.0 were used for statistical analysis.

Results: Five items were excluded from the original versions, forming five subscales that include a combined total of 23 items. The subscales are as follows: Factor 1 (Respect for right to information and decision), Factor 2 (Providing fair care), Factor 3 (Providing benefit-not harming), Factor 4 (Respect for patient values and choices), and Factor 5 (Attention to privacy). The I-NEBPPR model demonstrated robust construct validity with factor loadings ranging from 0.453 to 0.871. CFA showed satisfactory model fit indices (χ2/df = 1.554 (p <0.001), GFI = 0.906, CFI = 0.929, IFI = 0.930, RMSEA = 0.044). Reliability metrics were solid, with a Cronbach’s alpha of 0.819 and composite reliability exceeding 0.6. Both convergent validity, as indicated by AVE, and discriminant validity, as confirmed by the Fornell-Larcker criterion, met established thresholds.

Conclusion: It is affirmed that the 23-item I-NEBPPR demonstrated strong psychometric properties, making it a valuable, practical, and time-efficient tool for nurse supervisors, nurse managers, and nurse leaders to assess nurses’ clinically-based ethical behavior in their efforts to protect patient’s rights.

https://doi.org/10.33546/bnj.2921
PDF
XML

Copyright

Copyright (c) 2023 Dian Susmairni, Do Thi Ninh, Cheng Li, GunJeong Lee

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 155 [Abstract: 72 | PDF: 74 | XML: 9 ]

Downloads

Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors had no conflict of interest to declare.

Acknowledgment

The authors would like to thank the original authors Eyuboglu et al., 2022 of the NEBPPR questionnaire for permitting the questionnaire adaptation and Indonesian nurses for participating in this study.

Authors’ Contributions

DS, DTN, and CL determined the questionnaire and prepared the proposal. DS and CL designed the data collection. DS, DTN, CL, and GL analyzed the data. DS, DTN, CL, and GL wrote the paper. All authors were accountable for each step of the study and approved the final version of the article to be published.

Data Availability

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


References

Aiken, L. R. (1985). Three coefficients for analyzing the reliability and validity of ratings. Educational and Psychological Measurement, 45(1), 131-142.

Alloubani, A., Khater, W., Akhu-Zaheya, L., Almomani, M., & Alashram, S. (2021). Nurses' ethics in the care of patients during the COVID-19 pandemic. Frontiers in Medicine, 8, 589550. https://doi.org/10.3389/fmed.2021.589550

Ayla, I. A., Ozyazicioglu, N., Atak, M., & Surenler, S. (2018). Determination of professional values in nursing students. International Journal of Caring Sciences, 11(1), 254-261.

Carmines, E. G., & Zeller, R. A. (1979). Reliability and validity assessment. Thousand Oaks: Sage Publications.

Eyuboglu, G., Eyikara, E., Gocmen Baykara, Z., & Gul, S. (2022). Development, reliability and validity of the nurses' ethical behaviours for protecting patient rights scale. International Journal of Nursing Practice, 28(1), e12991. https://doi.org/10.1111/ijn.12991

Fan, X., Thompson, B., & Wang, L. (1999). Effects of sample size, estimation methods, and model specification on structural equation modeling fit indexes. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 56-83. https://doi.org/10.1080/10705519909540119

Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research, 18(3), 382-388. https://doi.org/10.1177/002224378101800313

Guadagnoli, E., & Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103(2), 265-275. https://doi.org/10.1037/0033-2909.103.2.265

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258-272. https://doi.org/10.1177/0969733019832941

Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. Treasure Island, FL: StatPearls Publishing.

Hair Jr, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2014). A primer on partial least squares structural equation modeling (PLS-SEM). London: Sage Publications.

Hinton, P. R., McMurray, I., & Brownlow, C. (2014). SPSS explained. London: Routledge.

International Council of Nurses (ICN). (2021). The ICN code of ethics for nurses (Revised ed.). Geneva, Switzerland: International Council of Nurses. https://www.icn.ch/sites/default/files/2023-06/ICN_Code-of-Ethics_EN_Web.pdf

Kaya, A., & Boz, İ. (2019). The development of the professional values model in nursing. Nursing Ethics, 26(3), 914-923. https://doi.org/10.1177/0969733017730685

Krabbe, P. F. M. (2017). Chapter 7 - Validity. In P. F. M. Krabbe (Ed.), The measurement of health and health status (pp. 113-134). Academic Press. https://doi.org/10.1016/B978-0-12-801504-9.00007-6

MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1(2), 130-149. https://doi.org/10.1037/1082-989X.1.2.130

Menon, V., & Muraleedharan, A. (2020). Internet-based surveys: Relevance, methodological considerations and troubleshooting strategies. General Psychiatry, 33(5), e100264. https://doi.org/10.1136%2Fgpsych-2020-100264

Penfield, R. D., & Giacobbi, J. P. R. (2004). Applying a score confidence interval to Aiken's item content-relevance index. Measurement in Physical Education and Exercise Science, 8(4), 213-225. https://doi.org/10.1207/s15327841mpee0804_3

Pramono, W. H. (2018). Tanggung jawab hukum keperawatan terhadap rahasia kesehatan pasien di Rumah Sakit Kota Semarang [Nursing law responsibilities to patient health secrets in Semarang City Hospital]. Jurnal Riset Media Keperawatan, 1(1), 28-36. https://doi.org/10.51851/jrmk.v1i1.4

Revicki, D. (2014). Internal consistency reliability. In A. C. Michalos (Ed.), Encyclopedia of quality of life and well-being research (pp. 3305-3306). Springer Netherlands. https://doi.org/10.1007/978-94-007-0753-5_1494

Robichaux, C., Grace, P., Bartlett, J., Stokes, F., Saulo Lewis, M., & Turner, M. (2022). Ethics education for nurses: Foundations for an integrated curriculum. Journal of Nursing Education, 61(3), 123-130. https://doi.org/10.3928/01484834-20220109-02

Sidin, I., & Rivai, F. (2020). Organizational citizenship behavior perawat etnis Bugis di Sulawesi Selatan. HIGEIA (Journal of Public Health Research and Development), 4(1), 12-22. https://doi.org/10.15294/higeia.v4i1.33681

Stevens, J. P., & Stevens, J. (1992). Applied multivariate statistics for the social sciences (2nd ed.). New Jersey: L. Erlbaum Associates.

Taber, K. S. (2018). The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48, 1273-1296. https://doi.org/10.1007/s11165-016-9602-2

Tariq, R. A., & Hackert, P. B. (2018). Patient confidentiality. Treasure Island, FL: StatPearls Publishing.

Tsang, S., Royse, C. F., & Terkawi, A. S. (2017). Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia, 11(Suppl 1), S80-S89. https://doi.org/10.4103%2Fsja.SJA_203_17

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119

Vitolla, F., Raimo, N., Rubino, M., & Garegnani, G. M. (2021). Do cultural differences impact ethical issues? Exploring the relationship between national culture and quality of code of ethics. Journal of International Management, 27(1), 100823. https://doi.org/10.1016/j.intman.2021.100823

West, R. F., Meserve, R. J., & Stanovich, K. E. (2012). Cognitive sophistication does not attenuate the bias blind spot. Journal of Personality and Social Psychology, 103(3), 506-519. https://doi.org/10.1037/a0028857

World Health Organization (WHO). (2012). WHODAS 2.0 Translation package (Version 1.0): Translation and linguistic evaluation protocol and supporting material. https://terrance.who.int/mediacentre/data/WHODAS/Guidelines/WHODAS%202.0%20Translation%20guidelines.pdf

Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., Maddah, S. S. B., Cheraghi, M. A., Mirzabeigi, G. H., & Larijani, B. (2013). The code of ethics for nurses. Iranian Journal of Public Health, 42(Supple1), 1-8.


Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system