Development and psychometric analysis of the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale (PPPNBS)

Aim. To ( 1) develop and psychometrically test the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale, which measures patient perceptions of empowering nurse behaviours during hospitalization; and ( 2) refine to a shorter, more useful form, for measurement in clinical settings. Background. Although patient empowerment has been promoted as a way to engage patients in chronic illness care, there is not a measure reported by patients as recipients of empowering nurse behaviours during hospitalization. Design. Psychometric evaluation of construct and predictive validity, reliability and item reduction. Method. Data gathered during hospitalization and six weeks postdischarge between April 2012 - August 2014 were used to determine the validity and reliability of the long and short-form Patient Perceptions of Patient-Empowering Nurse Behaviours Scale in a sample of 395 chronically ill medical and surgical adult patients. Results. The long and short-form Patient Perceptions of Patient-Empowering Nurse Behaviours Scale demonstrated strong reliability and convergent validity with pre-discharge 13-item Patient Activation Measure scores. Both forms of the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale predicted postdischarge 13-item Patient Activation Measure scores and the long-form predicted physical health status. Confirmatory factor analysis demonstrated improved model fit for the short-form instrument when compared with the long-form fit. The short-form Patient Perceptions of Patient-Empowering Nurse Behaviours Scale explained 98% of the variance of the long-form Patient Perceptions of Patient-Empowering Nurse Behaviours Scale. Conclusion. The results provide evidence supporting reliability and validity of both forms. While the scales measure patient reports and not direct observation of empowering nurse behaviours, incorporating patients' experiences as recipients of care is necessary to validate the contribution of nursing care to patients' engagement in chronic illness management.