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

Area of Science:

• Nursing Leadership
• Healthcare Ethics
• Psychometrics

Background:

• Ethical decision-making confidence is crucial for nurse leaders but lacks a standardized measurement tool.
• Existing literature does not provide a framework to assess nurse leaders' confidence in ethical decision-making.

Purpose of the Study:

• To develop and validate the Ethical Decision-Making Confidence (EDMC) scale.
• To compare ethical decision-making confidence among nurse leaders in the U.S. and German-speaking European countries.

Main Methods:

• A cross-sectional survey was conducted with nurse leaders from the U.S. and three German-speaking European countries.
• A 15-item, bi-dimensional EDMC scale was developed using principal component analysis (PCA).
• The scale measures skill-related and behavior-related confidence in ethical decision-making.

Main Results:

• The EDMC scale demonstrated good-to-excellent internal consistency and a shared factor structure across countries.
• U.S. nurse leaders reported higher mean EDMC scores than their German-speaking counterparts.
• The scale identified distinct skill-related and behavior-related confidence dimensions.

Conclusions:

• The newly developed EDMC scale is an effective tool for measuring ethical decision-making confidence in nurse leaders.
• The study provides an initial international comparison of nurse leaders' ethical decision-making confidence.
• Further research with diverse populations is recommended to ensure the scale's validity and reliability.