Measuring nursing work in long-term care. The reliability and validity of the Leatt Measure of Nursing Technology

A projected 400% increase in the number of people age 85 and older by the year 2010, with one fourth of them needing nursing home care, forces attention on long-term care. This study establishes the validity and reliability of the Leatt Measure of Nursing Technology (LMNT) as a measure of the nature of nursing work in long-term care settings. The LMNT subscales measure the amount of uncertainty, instability, and variability of work which includes, but is not limited to, the technical equipment used. The LMNT was administered to licensed nursing staff in nine long-term care facilities in the Seattle area to evaluate its use in this environment. The nursing homes represented both for-profit and not-for-profit, and large (more than 250 beds) and small (70 beds) facilities. A total of 113 usable questionnaires were returned (45% response rate). Cronbach's alpha for subscales were .71 for Uncertainty, .66 for Instability, and .56 for Variability, with .77 for the total scale. Construct validity was evaluated by factor analysis, which confirmed the original factor structure. Content validity was evaluated using focus group discussions with key informants at each facility. A comparative analysis was used to determine major and minor themes in each of the instrument subscale topic areas. Qualitative analysis, combined with reliability and item level analyses, resulted in suggested minor changes in the instrument to make it more usable in long-term care settings. While some revisions are suggested, a concerted effort must be made to preserve the ability to compare findings with those obtained using the LMNT in acute care settings by retaining the general structures and factors of the measure.