Development and Validation of the Health Belief Model-Based Occupational Exposure Risk Perception Scale for Nursing...

Nursing staff frequently encounter serious occupational exposure risks that may adversely affect both their physical well-being and mental health. Their awareness of these risks plays a pivotal role in shaping protective behaviors and influencing how they recognize and respond to workplace hazards. However, existing assessment tools have several limitations, including a lack of robust theoretical foundation and an inability to reflect the complexity of contemporary clinical environments.

This multiphase study developed and validated a scale based on the Health Belief Model (HBM). The process included a structured literature review for item generation, a two-round Delphi consultation, a pilot survey (400 nurses) with exploratory factor analysis (EFA), and a cross-sectional validation sample (1250 nurses) using confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha and the Spearman-Brown split-half coefficient.

The final scale comprised 32 items organized into five theoretically grounded dimensions: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy. The results of EFA and CFA supported the proposed five-factor model. Fit indices suggested an acceptable model fit: chi-square/df = 2.941; RMSEA = 0.039; CFI = 0.974; NFI = 0.961; IFI = 0.974. The overall Cronbach's alpha was 0.927. The total Spearman-Brown split-half coefficient was 0.659, and dimension-level coefficients ranged from 0.832 to 0.937.

The proposed HBM-based Occupational Exposure Risk Perception Scale (HBM-OERPS) showed initial validity evidence and good internal consistency for assessing nurses' perceptions of occupational hazards within an HBM framework.

The HBM-OERPS provides an effective tool for future assessment of occupational exposure risk beliefs among nursing staff. This approach assists in identifying domain-specific risk-belief deficits and guides the design of targeted occupational safety education, resource allocation, and management strategies.