Development and validation of the conscientious objection in nursing care scale: a methodological study

Area of Science:

• Nursing Ethics
• Healthcare Professional Well-being
• Moral Distress in Healthcare

Background:

• Conscientious objection in nursing care presents a significant ethical challenge, impacting nurses' moral integrity and causing distress.
• The conflict between professional duties and personal values creates an emotional and ethical burden, leading to stress and feelings of inadequacy.

Purpose of the Study:

• To develop and validate a reliable scale for assessing conscientious objection in nursing care.
• To provide a tool for understanding nurses' experiences with conscientious objection.

Main Methods:

• Psychometric analyses were performed on data from 165 nurses in Türkiye.
• Exploratory factor analysis, reliability testing, and thematic analysis of open-ended questions were utilized.

Main Results:

• The Conscientious Objection in Nursing Care Scale (COSINC) has 20 items across four factors, explaining 59.4% of the variance.
• High reliability was demonstrated (Cronbach's alpha 0.887 for the total scale).
• Thematic analysis identified themes of value system conflicts, conscientious conflict, and deviation from values.

Conclusions:

• The COSINC is a valid and reliable instrument for evaluating nurses' attitudes towards conscientious objection.
• This scale can aid in developing institutional policies to address conscience-based ethical issues in clinical practice.