Development and validation of a nursing practice scale for supporting fertility preservation decision-making in women...

With increasing attention to fertility preservation (FP) among women with cancer, nursing support for FP decision-making remains insufficient and lacks standardization. Nurses often face challenges such as limited knowledge, inconsistent practices, and the absence of structured decision-support frameworks. This study aimed to develop and psychometrically validate a scale to assess nursing practices that support FP decision-making in women with cancer.

The study comprised two phases: scale development and psychometric evaluation. In Phase 1, an initial item pool was generated through a literature review, expert consultation, and content validity assessment. In Phase 2, a cross-sectional survey was conducted among 600 nurses, who were divided into exploratory factor analysis (EFA; n ​= ​282) and confirmatory factor analysis (CFA; n ​= ​318) groups. Construct validity was examined using EFA and CFA, and criterion-related, convergent, and discriminant validity were evaluated. Reliability was tested using Cronbach's α.

The preliminary 22-item, four-factor scale demonstrated strong content validity. Subsequent analyses produced a refined 12-item scale comprising three factors: (1) providing professional support for patients'FP decision-making, (2) facilitating communication between patients and families, and (3) promoting system-based and team-oriented FP support. The scale demonstrated excellent internal consistency (Cronbach's α ​= ​0.921). CFA indicated good model fit (Comparative Fit Index ​= ​0.969, Tucker-Lewis Index ​= ​0.960, Root Mean Square Error of Approximation ​= ​0.077; P ​< ​0.001).

This study developed a reliable and valid 12-item, three-factor scale to assess nursing practices supporting FP decision-making in women with cancer. The scale may serve as a useful tool for evaluating and enhancing patient-centered FP care in oncology nursing practice.