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Updated: May 12, 2026
Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
Development and validation of a questionnaire measuring healthcare professionals' individual perceptions of advanced
Tim Hubo1, Karolien D'Hollander1, Lise-Marie Kinnaer1
1Department of Public Health and Primary Care, University Centre of Nursing and Midwifery, Ghent University, Belgium.
Objective:
To develop, and to face and content validate a questionnaire that measures healthcare professionals' individual perceptions of advanced practice nurses' contributions to team functioning.
Design:
A three-phase approach including a rapid review, a two-round modified international Delphi procedure, and cognitive interviews.
Methods:
A questionnaire was derived from a rapid review of international literature and grey literature. Face and content validity were assessed through a two-round modified Delphi procedure involving international experts from various professional backgrounds (advanced practice nurses, healthcare professionals, managers, and academics) and healthcare settings (primary care, hospital care, mental healthcare, and long-term residential care). Seven healthcare professionals participated in cognitive interviews to test the questionnaire's clarity and comprehensibility.
Results:
Initially, the questionnaire consisted of 102 outcomes organised into 14 domains. Two Delphi rounds with 27 and 23 experts respectively led to refinement, merging, or removal of outcomes based on item-level content validity indices, comprehensibility scores, and qualitative feedback. Cognitive interviews led to further rephrasing of unclear outcomes. The final questionnaire comprises 67 outcomes across 11 domains: innovation and quality culture, support and application of evidence-based practice, healthcare team capacity building, advanced practice nurse role clarity, acceptance and satisfaction, healthcare team members' perception of their own professional role, workload and job satisfaction, communication policy, clinical decision-making, problem-solving and conflict management, continuity of care, and collaborative practice and sense of belonging.
Conclusions:
This study developed and content validated the first comprehensive questionnaire to measure healthcare professionals' individual perceptions of advanced practice nurses' contributions to team functioning across diverse healthcare settings. The questionnaire is suitable for use by professionals working in teams with advanced practice nurses across diverse care settings.
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