Tools

Et h i c s To o l Da t a b a s e
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Tabl e of Contents
ETHICS TOOLS DATABASE
I Decision Making (DM)
1.0 Competence (DM/ C)
Assessment of Patient Competence (APC) .............................. 7
2.0 Factor s (DM/ F)
Ethics Str ess Scal e ................................................................ 8
Attr ibution of Responsibil ity Instr ument (ARI) ........................ 9
The Autonomy Pr efer ence Index (API) .................................10
The Inventor y of Cognitive Biases in Medicine (ICBM)...........11
3.0 Rol es (DM/ R)
Mazur s Patient Pr efer ence Tool (MPPT) ...............................12
Kr antz Heal th Opinion Sur vey (HOS) ....................................13
4.0 Satisfaction (DM/ SA)
Satisfaction with Decision Scal e (SWD) .................................14
Job Satisfaction Scal e ......................................................... 15
5.0 Styl es (DM/ S)
Case Vignettes of Restr ictive Situations in Psychiatr ic Car e .. 16
Par ticipator y Decision- Making Styl es (PDMS) .............. ........17
II Ethical Behavior s (EB)
1.0 ANA Code (EB/ Code)
Judgments About Nur sing Decisions (JAND)..........................18
Judgements about Nur sing Decisions (JAND), Adaptation by
Rooks (1994)......................................................................19
2.0 Car ing (EB/ Car ing)
Car ing Behavior s Assessment (CBA)....................................20
Recal l Tasks & Cl inical Dil emma Questionnair e ................... 21
Car ing Assessment Repor t Eval uation (CARE - Q) .................22
Nur se Car ing Questionnair e (NCQ); Patient Car ing Questionnair e
(PCQ)................................................................................. 23
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Tabl e of Contents
Car ing Behavior s Inventor y (CBI)........................................ 24
Car e and Justice Inter view ................................................. 25
3.0 Coping (EB/ CP)
Jal owiec Coping Scal e ........................................................ 26
Coping Styl es Inventor y (CSI).............................................. 27
4.0 Empathy (EB/ EM)
Behavior Test of Inter per sonal Skil l s (BTIS) ..........................28
Bar r et- Lennar d Rel ationship Inventor y (BLRI) .................... 29
Inventor y of Social l y Suppor tive Behavior s (ISSB)................ 30
Empathic Under standing in Inter per sonal Pr ocesses
(EUIPASM) ......................................................................... 31
5.0 Humanistic (EB/ HUM)
Scal e of Humanistic Nur sing Behavior s ................................32
6.0 Recipr ocity (EB/ R)
Car egiver Recipr ocity Scal e (CRS) ...................................... 33
7.0 Sel f- Deter mining (EB/ SD)
Per ceived Enactment of Autonomy (PEA Scal e).................... 34
Competency Inter view Schedul e (CIS) .................................35
8.0 Tr uthtel l ing (EB/ TR)
Tr uthtel l ing Inter view Schedul e .......................................... 36
9.0 Unethical (EB/ UETH)
Unethical Teaching Behavior s Tool ......................................37
III Ethical Pr obl ems (EP)
1.0 Ethical Issues (EP/ EI)
Ethical Issue Scal e (EIS) .......................................................38
Mor al Pr obl ems ..................................................................39
ICU and Ethics .....................................................................40
2.0 Euthanasia/ Assisted Suicide (EP/ EAS)
Assisted Suicide & Patient Requested Euthanasia Tool ..........41
3.0 Life Suppor t (EP/ LS)
Advance Dir ective Questionnair e ........................................42
Life Suppor t Pr efer ences Questionnair e (LSPQ) ................... 43
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Tabl e of Contents
Sur vey of impl ementation and impact of (PSDA) .................. 44
4.0 Mor al Distr ess (EP/ MD)
Mor al Distr ess Scal e .......................................................... 45
5.0 Pain (EP/ P)
The Bar r ier s Questionnair e (BQ) ......................................... 46
6.0 Physical Restr aint Use (EP/ PR)
Revised Restr aint Questionnair e .........................................47
knowl ege and Ethics of Restr aint .........................................48
7.0 Qual ity of Life (EP/ QOL)
Qual ity of Life Questionnair e .............................................. 49
Qual ity of Life Sel f- Assessment - Cancer Patients ................ 50
Qual ity of Life - Adul ts with Chr onic Il l nesses .......................51
Per ceptual Qual ity of Life Inter view / Questionnair e ............ 52
Enfor ced Social Dependency Scal e (ESDS) ............................53
McMaster Qual ity of Life Scal e(MQLS) .................................54
Sickness Impact Pr ofil e (SIP) ............................................... 55
Qual ity of l ife Sur vey (QLS) ................................................. 57
Qual ity of Wel l Being Scal e (QWB) ....................................... 58
Qual ity of Life Index (QLI) ................................................... 59
Symptom Distr ess Scal e ......................................................60
Qual ity of Life Cancer Scal e (QOV- CA) .................................61
MOS Shor t For m ................................................................. 62
IV Mor al Reasoning (MR)
1.0 Car e Ethics (MR/ CE)
2.0 Gener al (MR/ G)
Responses to DNR or der s in the NICU ...................................63
Defining Issues Test (DIT- 1 A & DIT- 2) ................................ 64
Nur sing Dil emma Test (NDT) ............................................... 65
Ethical Behavior Inventor y ................................................. 66
Advocacy Assessment Tool ................................................ 67
3.0 Heal th Car e (MR/ HC)
Heal th Car e Decision - Making Questionnair e
(Nur ses Ver sion) ................................................................ 68
4.0 Pr incipl ed Ethics (MR/ PE)
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Tabl e of Contents
Val ues in the Choice of Tr eatment Inventor y ........................69
Ethical Reasoning in Ter minal Car e Inter view ......................70
5.0 Sociomor al Reasoning (MR/ SM)
Social Refl ection Measur e (SRM) .........................................71
Mor al Judgment Inter view: Kohl ber g (MJI) ...........................72
V Val ues / Attitudes: (V/ A)
1.0 Death (V/ A/ D)
Thr eat Index- el icited for m (TIE) ......................................... 73
Thr eat Index- Pr ovided for ms (Tip40) ................................. 74
Templ er Death Anxiety Scal e (DAS) ..................................... 75
Col l et- Lester Fear of Death Scal e (FDS) ................................76
2.0 Gener al (V/ A/ G)
Attitudes Towar d Advance Dir ectives .................................. 77
Pankr atz Nur sing Autonomy & Patients Right Scal e ............ 78
Bl aney/ Hobson Nur sing Attitude Scal e ................................ 79
Sur vey of Ethical Attitudes .................................................. 80
Val ues Histor y ................................................................... 81
Al l por t- Ver non- Lindzey Study of Val ues............................ 82
Attitudes Towar d Resour ce Use ...........................................83
Val ues Confl ict Resol ution Assessment (VCRA) .....................84
Val ues Scal e ...................................................................... 85
Attitudes Towar d Car e at the End - of- Life (ATCEL) .............. 86
3.0 Moods (V/ A/ M)
Pr ofil e of Mood States Inventor y (POMS) .............................87
Mul tipl e Affect Adjective Check List (MAACL) ........................88
Behavior Mor al e Scal e ....................................................... 89
Pr ofil e of Mood States Inventor y - Shor t Ver sion (PMOS)...... 90
Life Regar d Index (LRI) ....................................................... 91
Abbr eviated Lonel iness Scal e, Ver sion 2 (ABLS - 2...............92
4.0 Pr offesional (V/ A/ P)
Nur sing Pr ofessional Val ues Scal e.......................................93
Rol e Responsibil ities Questionnair e.....................................94
Whistl e Bl owing .................................................................95
5.0 Spir itual (V/ A/ SP)
Rel igious Bel iefs Instr ument ............................................... 96
Infl uence of Spir itual Wel l Being Scal e (SWBS)..................... 97
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Tabl e of Contents
Spir itual Wel l Being Questionnair e ......................................98
JAREL Spir itual Wel l - Being Scal e ....................................... 99
VI Ethics (E)
1.0 Ethics Consul tation (E/ EC)
Bioethics Consul tation Questionnair e ................................100
2.0 Patient Outcomes (E/ PO)
Il l ness Sever ity Measur es .................................................101
SERVQUAL ........................................................................102
SERVQUAL- Shor t for m .....................................................103
VII Wor l d Views (W/ V)
1.0 Ethical Ideol ogies (WV/ EI)
Ethics Position Questionnair e ............................................104
2.0 Resear ch (WV/ RS)
Wor l dViews of Facul ty Resear ch Investigator s ...................105
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Tabl e of Contents
Thi s l i st i s an i nf or mat i onal
r esour ce onl y. We do not keep
t he t ool s or i nst r ument s her e.
I f you wi sh t o access t he
compl et e t ool i t i s best t o
cont act t he aut hor (s) di r ect l y
f or per mi ssi on.
7
DESCRI PTI ON: The tool has specific
questions about a patient scenar io
and questi ons about the l aw.
Par t I - scenar i o based on
Massachusetts Appel ate Cour t
decision: Lane v. Car dur a, 6 Mass.
App. Ct. 377.1978. Par t II - ser ies of
mul ti pl e choi ce, theor eti cal
questions about the l aw per taining
to competence. The enti r e tool i s
i ncl uded i n the above- menti oned
ar ticl e.
Assesment oF Pat i ent
Compet ence ( APC)
WHERE TO FI ND THE ARTI CLE:
Mar kson, L., Ker n, D., Annas, G. and
Gl antz, L. (1994). Physi ci an
assessment of patient competence.
Jour nal of Amer i can Ger i atr i cs
Society, 42, 1074- 1080.
COMPETENCE 1. 0
PURPOSE: Deter mines physicians
knowl edge of appl yi ng l egal
standar d for deter mi ni ng
competence; and, deter mi nes
physi ci ans abi l i ti es to assess
competence by physi ci an age or
special ty.
BACKGROUND: Unknown
RELI ABI LI TY: Not pr ovided
VALI DI TY: The i nstr ument was
r eviewed for face val idity by both
cl inicians and l awyer s.
7
De c i si o n Ma k i n g
8
Et hi cs St r ess Scal e-
Luna- Ty mchuk
VALI DI TY: Not pr ovided.
BACKGROUND: Thi s new
instr ument for measur ing the str ess
that heal th car e pr ofessional s may
exper i ence as they face ethi cal
issues with their patients, col l eagues
or r esear ch subjects was devel oped
by the author to use al ong with Dr .
Anna Omer ys Mor al Reasoni ng
Questi onnai r e and Lazar us and
Fol kmans Way of Copi ng i n her
di sser tati on r esear ch on
" Psychol ogi cal Factor s Infl uenci ng
Ethi cal Deci si on Maki ng" . The
instr ument was tested in 1990.
DESCRI TPTI ON: The scal e consists
of 43 items; par ticipants r ank each
for fr equency of encounter and
choose a number r efl ecting intensity
of r el ated str ess, 0 = never , 1 = mil d
to 7 = ver y str ong.
Not avail abl e.
FACTORS 2. 0
PURPOSE: Measur es str ess r el ated
to ethical decision- making by heal th
car e pr ofessional s.
RELI ABI LI TY: Not pr ovided.
9
At t r i but i on of
Responsi bi l i t y
I nst r ument ( ARI )
FACTORS 2. 0
RELI ABI LI TY: A pil ot study of 53
senior femal e BSN students and 25
femal e gr aduate nur si ng students
yiel ded Cr onbachs al pha r el iabil ity
coeffi ci ent of .85. Stabi l i ty was
establ ished by r eadminister ing the
questionnair es to 25 subjects wer e
r andoml y sel ected fr om the or iginal
sampl e of 78 subjects. Five weeks
after the i ni ti al admi ni str ati on;
test- r etest r el iabil ity coefficient was
.63. The amount of attr i buti on of
r esponsibil ity assigned did not differ
for the two gr oups (t = 0.02, p>. 05).
The dil emma sol ution did not differ
significantl y between the gr oups.
VALI DI TY: Content val i di ty was
establ ished by two social psychol o-
gi sts who agr eed that each
statement r epr esented the
designated ARI l evel .
education on thr ee sel ected factor s:
ethical / mor al r easoning, attr ibution
of r esponsibil ity, and ethical / mor al
di l emma r esol uti on. The r esul ts
suggest that under gr aduate and
gr aduate nur si ng pr ogr ams must
pl ace mor e emphasis on identifying
dil emmas, incr easing ethical / mor al
r easoni ng l evel s and attr i buti ng
r esponsi bi l i ty i n a j usti fi abl e
manner .
PURPOSE: Measur es the
attr i buti on of r esponsi bi l i ty i n
r el ation to ethical / mor al dil emmas.
Fel ton, G. M. and Par sons, M.A.
(1987). The i mpact of nur si ng
educati on on ethi cal / mor al
decision- making. Jour nal of Nur sing
Education, 26, 7- 11.
DESCRI TPTI ON: The Attr ibution of
Responsi bi l i ty Instr ument was
devel oped to measur e the
attr i buti on of r esponsi bi l i ty i n
r el ation to ethical / mor al dil emmas.
ARI measur ed the commi ssi on,
for eseeabi l i ty, i ntenti onal l y, and
justification l evel s of r esponsibil ity.
BACKGROUND: Devel oped to
eval uate the i nfl uence of for mal
10
Aut onomy Pr ef er ence
I ndex ( API )
RELI ABI LI TY: Test- r etest: 0.84 for
deci si on maki ng and 0.83 for
i nfor mati on seeki ng Cr onbachs
al pha: 0.82 for each.
VALI DI TY: Concur r ent val i di ty of
the deci si on maki ng scal e was
establ ished by cor r el ation with an
empi r i cal l y r el ated gl obal i tem
appended to the instr ument; r = 0.54,
p = < 0.0001. Conver gent val idity
was obtained by administer ing the
deci si on maki ng scal e to di abeti c
patients.
BACKGROUND: In an er a in which
pati ent autonomy has become a
tenet of medi cal ethi cs, r el ati vel y
l ittl e attention has been given to the
question of how much invol vement
i n thei r own car e pati ents r eal l y
want. A modi fi ed Del phi study
i nvol vi ng 13 cl i ni ci ans, medi cal
soci ol ogi sts, and ethi ci sts was
or ganized to assist in identification
of the key measur abl e dimensions of
patients pr efer ences for autonomy.
PURPOSE: Measur es pati ents
pr efer ences for two i denti fi ed
dimensions of autonomy.
Ende, J., Kazi s, L., Ash, A. and
Moskowi tz, M. (1989) Measur i ng
pati ents desi r e for autonomy;
decision making and infor mation-
seeking pr efer ences among medical
students. Jour nal of Gener al Inter nal
Medicine, 4, 23- 30.
DESCRI TPTI ON: The API consists of
two scal es: an 8 i tem scal e on
infor mation seeking and a 15 item
scal e on deci si on maki ng. Items
scor ed on a 5 point Liker t scal e and
total scor es wer e adjusted l inear l y
to r ange fr om 0 (no desir e) to 100
(str ong desi r e). Thr ee cl i ni cal
vi gnettes wer e used to r epr esent
differ ent l evel s of il l ness sever ity for
the decision making scal e.
10
FACTORS 2. 0
11
DESCRI TPTI ON: The ICBM contains
22 medi cal scenar i os i n whi ch
r espondents choose between
al ter nati ves that r epr esent
bi as- pr one or stati sti cal l y based
decisions.
The I nv ent or y of
Congni t i v e Bi ases i n
Medi ci ne ( I CBM)
FACTORS 2. 0
RELI ABI LI TY: Kuder - Ri char dson
20 i nter nal consi stency r el i abi l i ty:
0.62 for facul ty and 0.42 for
students. The shor t l ength (22 items)
of the ICBM pr evented the test fr om
havi ng a hi gher r el i abi l i ty. Gr oup
homogeneity was gr eater in student
and r esident gr oup than the facul ty
gr oup.
VALI DI TY: The ICBM appear s to
have content val i di ty. Items wer e
devel oped fr om actual cl i ni cal
exper iences r epor ted by physicians
and wer e scr utinized for incl usion
fr om the per specti ves of cl i ni cal
medicine, cognitive psychol ogy and
stati sti cs. Constr uct val i di ty i s
suppor ted by the fact that the facul ty
scor ed hi gher (7.5%) than di d
students and r esidents.
BACKGROUND: The ICBM was
devel oped to eval uate the
effecti veness of educati onal
inter ventions aimed at minimizing
the bi ases associ ated wi th
pr edictabl e infor mation- pr ocessing
tendenci es when maki ng medi cal
decisions. It can ser ve as a tr aining
tool in the educational pr ocess, and
PURPOSE: Measur es the infl uence
of cogni ti ve bi ases on medi cal
decisions.
Her shber ger , P., Par t, H., Mar ker t,
R., Cohen, S. and Finger , W. (1994).
Devel opment of a test of cognitive
bi as i n medi cal deci si on- maki ng.
Academic Medicine, 69 (10), 839-
842.
be used to compar e gr oups of
physi ci ans or physi ci ans- i n-
tr ai ni ng on the di mensi on of
cognitive bias.
11
12
Mazur s Pat i ent
Pr ef er ence Tool ( MPPT)
ROLES 3. 0
VALI DI TY: Not pr ovided
BACKGROUND: Unknown.
PURPOSE: To access the l evel of
i nvol vement pati ents want i n
deci si on maki ng r el ated to the
acceptance or r ej ecti on of an
invasive medical inter vention and
whether thei r pr efer ence for
decision making is r el ated to their
pr efer ence for qual itative (ver bal )
or quanti tati ve (numer i c)
infor mation about the r isks of the
pr ocedur e.
DESCRI TPTI ON: Defi ni ti ons wer e
given for pr ocedur e and r isk. In a
str uctur ed inter view, patients wer e
asked to answer 4 questions r el ated
to their pr efer ences in infor mation
discl osur e about pr ocedur es. A four
item demogr aphic tool asked: age,
educati onal l evel , pr esent heal th
and medical conditions.
Mazur , D. and Hi ckam, D. (1997).
Pati ents pr efer ences for r i sk
di scl osur e and r ol e i n deci si on
maki ng for i nvasi ve medi cal
pr ocedur es. Jour nal of Gener al
Inter nal Medicine, 12, 114- 117.
13
ROLES 3. 0
Kr ant z Heal t h Opi ni on
Sur v ey ( HOS)
RELI ABI LI TY: Rel i abi l i ti es of The
Behavi or al Invol vement and
Infor mation subscal es wer e .74 and
.76, r especti vel y. Kuder -
Richar dson 20 r el iabil ity of the HOS
for two subsequent col l ege sampl es
r emained over .74 for subscal es and
total scal e. Test- r etest r el iabil itys
for the HOS components wer e .74,
.71, and .59 for the total scor e,
Behavior al Invol vement scal e, and
Infor mati on scal es, r especti vel y.
Ther e is a sl ight but non- significant
tendency for femal es to scor e
somewhat higher than mal es on al l
HOS scal es.
VALI DI TY: Pr edictive Val idity: The
HOS successful l y di scr i mi nated
between a cr iter ion gr oup of high
sel f- car e subjects and the gener al
student popul ati on. Di scr i mi nate
vadi l i ty: Both subscal es show
di scr i mi nate val i di ty. Constr uct
val idity: is stil l being tested.
BACKGROUND: Al though cur r ent
ideol ogy suggests patients woul d be
active par tner s in decision making
about thei r car e, the l i ter atur e
PURPOSE: Measur e pati ents
attitudes towar d tr eatments.
DESCRI TPTI ON: HOS was
devel oped to measur e pati ent
atti tudes towar d tr eatment
appr oaches and uses two subscal es:
Infor mation (7 items) and Behavior
(9 i tems). A hi gh scor e denotes
favor abl e atti tudes towar d sel f-
di r ected or i nfor med tr eatment
par ti ci pati on, whi l e a l ow scor e
denotes a passive attitude. The total
combi ned scor e of the 2 a pr i or i
subscal es pr ovi des an over al l
measur e of attitude towar d medical
tr eatment.
Kr antz, D.S., Baum, A., Wil deman,
M.V. (1980). Assessment of
pr efer ences for sel f- tr eatment and
infor mation in heal th car e. Jour nal
of Per sonal i ty and Soci al
Psychol ogy, 39(5): 977- 990.
suggests that pati ents wi sh to be
infor med but not invol ved.
14
Sat i sf act i on w i t h
Deci si on Scal e ( SWD)
SATI SFACTI ON 4. 0
RELI ABI LI TY: Cr onbachs al pha is
0.86.
VALI DI TY: Di scr i mi nate val i di ty,
tested by per for mi ng pr i nci pal -
components anal ysi s of i tems
pool ed fr om the SWD scal e and two
conceptual l y r el ated measur es, was
good.
BACKGROUND: Patient satisfaction
measur es have pr evi ousl y
addr esses satisfaction with medical
car e, sati sfacti on wi th pr ovi der s,
and satisfaction with outcomes, but
not satisfaction with the heal th car e
deci si on i tsel f. The SWD was
devel oped i n the context of
post- menopausal hor mone-
r epl acement ther apy deci si ons to
hel p under stand specific dynamics
of the decision itsel f.
PURPOSE: The SWD measur es
patient satisfaction with heal th car e
decisions.
DESCRI TPTI ON: The SWD i s a
si x- i tem scal e and each i tem i s
scor ed on a 5 poi nt scal e (" ver y
cer tai n woul d not take " to " ver y
cer tain woul d take"). It can be used
in heal th car e settings to eval uate
deci si on- assi sti ng technol ogi es or
patient- pr ovider inter actions aimed
at i nvol vi ng pati ents i n deci si on
making.
Hol mes- Rovner , M., Kr ol l , J.,
Schmi tt, N., Rovner , D., Br eer , L.,
Rother t, M., Padonu, G. and
Tal ar czyk, G. (1996). Pati ent
sati sfacti on wi th heal th car e
deci si ons: The Sati sfacti on wi th
Deci si on Scal e. Medi cal Deci si on-
Making, 16 (1), 58- 64.
15
SATI SFACTI ON 4. 0
Job Sat i sf act i on Scal e
RELI ABI LI TY: Inter nal consistency:
al pha = 0.86.
BACKGROUND: Tool designed by
Pr ice and Muel l er , 1981.
PURPOSE: Measur es j ob
satisfaction.
DESCRI TPTI ON : 7 - su b sca l e
instr ument incor por ating 52 items
scor ed i n a var i ety of r anges.
Some questions ar e indicated on a 5
poi nt Li ker t scal e r angi ng fr om
= str ongl y disagr ee to 5 = str ongl y
agr ee.
Packar d, J. & Motowidl o, S. (1987)
Subj ecti ve str ess, j ob sati sfacti on
and j ob per for mance of hospi tal
nur ses. Resear ch i n Nur si ng &
Heal th, 10, 253- 261.
16
STYLES 5. 0
Case Vi gnet t es of
Rest r i ct i v e Si t uat i ons i n
Psy chi at r i c Car e ( RSPC)
RELI ABI LI TY: Test- r etest r el iabil ity
wi th 20 nur se speci al i sts demon-
str ated no significant differ ences in
r anki ngs for al l i nter venti ons for
each vignette.
assur ed by sel ecti ng si tuati ons
r epr esentative of a potential confl ict
between cl i ent needs, r i ghts, and
avail abl e r esour ces. The vignettes
and ethi cs- based i nter venti ons
wer e r evi ewed by a psychi atr i c
nur se ethi ci st who confi r med that
the i nter venti on accur atel y
r epr esented the appr opr iate ethical
pr incipl e. Content exper ts r eviewed
the vi gnettes and the i nter r ater
agr eement was .88.
BACKGROUND: Not known.
PURPOSE: Measur es nur ses
e t h i c a l l y - b a s e d n u r s i n g
inter ventions in sel ected situations
i l l ustr ate the di sci pl i nes ethi cal
r el ationship to cl ients and society.
DESCRI TPTI ON: The tool contains
thr ee case vi gnettes depi cti ng
r estr ictive situations in psychiatr ic
car e. Respondents r anked thr ee
i nter venti ons accor di ng to thei r
agr eement with the appr oach and
r ati onal e r epr esented by the
i nter venti on. In addi ti on, the
r espondent was asked to comment
onthe inter vention chosen fir st.
Gar r i tson, S.H. (1988). Ethi cal
decision making patter ns. Jour nal of
Psychosocial Nur sing, 26(4), 22- 29.
17
Par t i ci pat or y Deci si on-
Maki ng St y l es ( PDMS)
BACKGROUND: A r epr esentati ve
cr oss- sectional sampl e of patients
par ti ci pati ng i n the Medi cal
Outcomes Study char acter ized each
physi ci ans styl e by usi ng a sel f-
r epor ted questi onnai r e. A si ngl e
aver aged styl e scor e was gener ated
for each physi ci an. Styl e scor es
wer e compar ed among physicians
who differ ed in age, sex, minor ity
status, speci al ty, pr i mar y car e
tr aining or tr aining in inter viewing
skil l s, satisfaction with pr ofessional
autonomy, and pr actice vol ume.
PURPOSE: Measur es how patients
r ate their physicians par ticipator y
decision- making styl e.
DESCRI TPTI ON: The PDMS i s a
thr ee- item scal e. Patients ar e asked
to r ate their physicians styl e on a
five- point scal e in r espond to the
fol l owing thr ee questions: (1) If ther e
wer e a choice between tr eatments,
woul d this doctor ask you to hel p
make the decision?; (2) How often
does this doctor make an effor t to
gi ve you some contr ol over your
tr eatment?; (3) How often does this
doctor ask you to take some of the
r esponsi bi l i ty for your tr eatment?
Scor ing instr uctions ar e pr ovided.
Kapl an, S., Gr eenfiel d, S., Gandek,
B., Roger s, W. and War e, J. (1996).
Char acter i sti cs of physi ci ans wi th
par ti ci pator y deci si on- maki ng
styl es. Annal s of Inter nal Medicine,
124, 497- 504.
STYLES 5. 0
Et h i ca l Be h a v i o r s
18
ADAPATI ON/ COMMENTS: * In her
book, Mor al Reasoning and Ethical
Pr actice in Nur sing: An Integr ative
Revi ew, whi ch was co- author ed
with I Or mond, (1988, NLN Pub. No.
15- 2250) Ketefian descr ibes a thir d,
" C" col umn whi ch asks expl i ci tl y
what par ticipants woul d do. The C
col umn was found to have l ow
r el iabil ity and is not used * See C.A.
Rooks (1994) adaptation of Ketefian
tool - EB Code - 002
ANA CODE ( EB/ Code) 1. 0
RELI ABI LI TY: Cr onbachs coeffi-
cient al pha for col umn B r anged .66
- .73. Rel iabil ity for col umn A scor es
is l ow; it is not r ecommended for use
as a separ ate scal e i n hypothesi s
testing.*
VALI DI TY: Demonstr ated by
significant cor r el ation with the DIT
and compar i son of r esul ts for
sampl es of pr ofessi onal and
technical nur ses.
BACKGROUND: Case Vi gnettes
wer e der ived fr om appr oximatel y
100 stor ies fr om pr acticing nur ses
and wer e assessed by nur se
cl i ni ci ans as r epr esentati ve of
pr acti ce occur r ences; these wer e
fur ther devel oped with consul tants
and the Code for Nur ses.
PURPOSE: To measur e mor al
behavior in nur sing pr actice in two
dimensions: (1) pr ofessional l y ideal
mor al behavior congr uent with the
Code for Nur ses and (2) per ception
of r eal istical l y l ikel y mor al behavior
in nur sing pr actice.
Ketefi an, S. (1982). Tool
devel opment i n nur si ng
constr uction of as scal e to measur e
mor al behavi or . Jour nal of New
Yor k State Nur ses Association, 13,
13- 19.
DESCRI TPTI ON: The tool consi sts
of si x vi gnettes wi th yes/ no
r esponses r egar di ng what i deal l y
shoul d be done and what
r eal istical l y is l ikel y to be done by
the nur se facing the ethical dil emma
posed in the vignette. The vignettes
wer e tested i n a study of 43
pr ofessi onal nur ses and 36 nur se
technicians.
Judgement s About
Nur si ng Deci si ons ( JAND)
19
ANA CODE ( EB/ Code) 1. 0
RELI ABI LI TY: Inter nal consistency
r el iabil ity for Col umn B r esponses
was tested usi ng Cr onbachs
coeffi ci ent al pha whi ch showed a
r ange fr om .66 to .73 acr oss
differ ent sampl es of RNs (Ketefiam,
1987). For this study, the Col umn A
r esponses showed a coeffi ci ent
al pha of .70; and for Col umn B
r esponses, .71.
VALI DI TY: Content Val i di ty was
establ ished by Ketefian in 1982 and
1987, Conver gent Val i di ty was
establ ished by testing with the JAND
and the DIT. The Pear son pr oduct
moment cor r el ati on of Col umn B
r esponse with the DIT was .19, p <
.05; shar ed var i ances was onl y
3.6%. Constr uct val i di ty was
establ i shed by use of the known
gr oups technique in 1990.
BACKGROUND: The JAND was
adapted for the pur pose of this study
and i nvol ved 33 Eur opean
Amer ican, 26 Afr ican Amer ican, and
17 Fi l i pi no nur se subj ects. Mor al
choice was defined as the r esponse
to Col umn A of the JAND; mor al
action was defined as the r esponse
to Col umn B of the JAND.
PURPOSE: The pur pose of the study
was to i denti fy the mor al choi ces
and actions of for eign- educated &
domesti c nur ses i n hypotheti cal
ethical dil emmas.
Rooks, C.A. (1994). Cul tur al aspects
of mor al actions & mor al choices in
nur sing. (Disser tation: Univer sity of
Mar yl and, Bal ti mor e, gr aduate
school ).
Judgement s about
Nur si ng Deci si ons
( JAND) , Adapt at i ons by
Rooks ( 1994)
DESCRI TPTI ON: The JAND was
adapted by adding one additional
i tem to the set of statements
fol l owing each of the six vignettes.
This item al l owed nur se subjects to
wr ite in other possibil ities for action
whi ch was not l i sted among the
choices but which the nur se shoul d
and/ or woul d per for m.
20
CARI NG ( EB/ Car i ng) 2. 0
RELI ABI LI TY: Inter r ater : l ess an
0.75 wer e r ecategor ized into mor e
appr opr i ated subscal es Inter nal
consi stency. Cr onbachs al pha for
each of the seven subscal es.
Rel i abi l i ty coeffi ci ents: r anged for
0.66 to 0.90.
VALI DI TY: Face and content
val idity wer e establ ished by a panel
of four content special ists famil iar
with Watsons conceptual model .
BACKGROUND: The tool
oper ati onnal i zes the " car ati ve"
factor s that nur ses use as a
fr amewor k for the car ing pr ocess, as
pr oposed by Jean Watson.
PURPOSE: To i denti fy nur si ng
behavior s per ceived as indicator s of
car ing by patients.
Cr oni n, S. & Har r i son, B. (1988).
Impor tance of nur se car i ng
behavior s as per ceived by patients
after myocar dial infar ction. Hear t &
Lung, 17(4), 374- 380.
DESCRI TPTI ON: The CBA l i sts 61
nur si ng behavi or s or der ed i n 7
subscal es that ar e congr uent with
JeanWatsons car ati ve factor s.
Watsons 6th car atives factor was
omitted as a subscal e as the author s
assumed that cr eati ve
pr obl em- sol vi ng car i ng pr ocess
was inher ent in nur sing. Author s did
not give r anges for r esponses. A 5
Poi nt Li ker t type scal e was used.
Inter vi ews of 22(17 men and 5
women) who had been hospital ized
i n the CCU wer e conducted.
Fol l owi ng the i nter vi ew, subj ects
wer e asked to compl ete the CBA.
Car i ng Behav i or s
Assessment Tool CBA
21
Peter , E. & Gal l op, R. (1994). The
ethi c of car e: A compar i son of
nur si ng and medi cal students,
IMAGE, 26(1), 47- 51.
VALI DI TY: Not r epor ted
RELI ABI LI TY: Inter r ater r el iabil ity
between 75 to 84% agr eement was
establ i shed wi th Lyons Codi ng
Scheme.
PURPOSE: Thi s study was
conducted to answer the fol l owing
questions: 1) To what extent ar e car e
consi der ati ons r efl ected i n the
mor al r easoning of femal e nur sing
students?; 2) Ar e car e consider ations
r efl ected mor e i n the mor al
r easoni ng of nur si ng students (al l
femal e) than i n medi cal students
over al l ?; 3) Ar e car e consider ations
r efl ected mor e often in the mor al
BACKGROUND: Gil l igans theor y of
mor al devel opment and Kol hber gs
theor y of mor al devel opment
str uctur ed this study of 199 nur sing
and medical students who descr ibed
a r eal - l i fe mor al di l emma and
r esponded to a hypothetical cl inical
mor al dil emma. The study incl uded
68 femal e 3r d year nur si ng
students, 25 femal e 3r d & 4th year
medical students, & 25 mal e 3r d &
4th year medical students.
Recal l Tasks & Cl i ni cal
Di l emma Quest i onnai r e
r easoni ng of femal e nur si ng
students than i n femal e medi cal
students?; 4) Ar e car e consider ations
r efl ected mor e often in the mor al
r easoni ng of femal e medi cal
students than i n mal e medi cal
students?; and, 5) Ar e per sonal
dil emmas associated with a higher
use of car e consi der ati ons than
imper sonal dil emmas?
DESCRI TPTI ON: A modi fi ed ver -
sion of an instr ument devel oped by
Pr att fol l owing Lyons 1982 face- to-
face i nter vi ew. The questi onnai r e
consists of two par ts: Par t I: the Recal l
Tasks and Par t II: the Cl i ni cal
Di l emma. In Par t I, per sonal
dil emmas wer e descr ibed. In Par t II,
a dil emma is posed. Lyons Coding
Scheme was chosen to deter mine
the number of car e and j usti ce
consider ations made in r esponse to
the Recal l Task and Cl i ni cal
Dil emma.
22
DESCRI TPTI ON: The CARE- Q
consi sts of 50 behavi or al i tems
or der ed in six sub scal es of car ing.
Using the Car ing Assessment Repor t
Eval uati on Q- SORT (CARE- Q), 26
patients and 26 nur ses wer e asked
to assign a degr ee of impor tance to
each of the 50 nur si ng car i ng
behavior s in the CARE- Q.
McDer mott Keane, S., Chastain, and
B. and Rudi si l l , K (1987). Car i ng
nur se- pati ent per cepti ons,
Rehabil itation Nur sing, 12(4), 182-
188.
VALI DI TY: Repor ted in: Lar son, P.
(1981). Oncol ogy pati ents and
pr ofessional nur ses per ceptions of
i mpor tant car i ng behavi or s.
Doctor al Disser tation: Univer sity of
Cal ifor nia, San Fr ancisco. Univer sity
Micr ofil ms #81- 16511.
RELI ABI LI TY: Repor ted in: Lar son,
P. (1981). Oncol ogy pati ents and
pr ofessional nur ses per ceptions of
i mpor tant car i ng behavi or s.
Doctor al Disser tation: Univer sity of
Cal ifor nia, San Fr ancisco. Univer sity
Micr ofil ms #81- 16511.
PURPOSE: To obtain per ceptions of
impor tant nur se car ing behavior s.
BACKGROUND: Not Known.
Car i ng Assessment
Repor t Ev al uat i on Q-
Sor t ( CARE- Q)
23
DESCRI TPTI ON: The NCQ & PCQ
each consists of 61 items scor ed on a
5 point Liker t scal e r anging fr om 1 =
str ongl y di sagr ee to 3 = nei ther
agr ee/ nor disagr ee to 5 = str ongl y
agr ee.
Val entine, K. (1991). Nur se- patient
car i ng: Chal l engi ng our
conventional wisdom. In D. Gaut and
M. Lei ni nger (Eds.). Car i ng: The
Compassi onate Heal er , 99- 113.
NLN Pub: 15- 2401.
VALI DI TY: The conver gent val idity
i s confi r med by the aggr egate
measur es of car ing.
RELI ABI LI TY: Al pha i nter nal
consistency r el iabil ity estimates of
.99 each.
PURPOSE: To measur e the
pr esence of car i ng whi ch had
occur r ed between speci fi c
nur se- patient inter actions.
BACKGROUND: For thi s study
invol ving 91 hyster ectomy patients
& their nur ses, the measur ement of
congr uence occur r ed wi thi n the
context of a l ar ger study. The l ar ger
study used a natur al istic appr oach to
define car ing and its r el ationship to
pr oducti vi ty and heal th outcome
var i abl es. Wi thi n the l ar ger study
the conceptual domain of car ing was
specified thr ough the use of mul tipl e
measur es and methods. Based on
qual i tati ve data fr om the domai n
specification phase, the NCQ & PCQ
wer e devel oped.
Nur se Car i ng
Quest i onnai r e ( NCQ)
24
RELI ABI LI TY: Test- r etest
r el iabil ity was establ ished: r = .96, p
=.000, r ho = .88, p = .000. The al pha
coeffi ci ent was .83. Inter nal
consi stency r el i abi l i ty was: Al pha
coefficient of .96 for the combined
nur ses and pati ent sampl e.
Unpai r ed t- test r eveal ed that the
gr oups wer e differ ent: t = 3.01, of =
539, p = .003.
VALI DI TY: Constr uct val idity of the
contr asted gr oups nur sing staff (n=
278) and pati ent (n= 263) was
establ ished.
BACKGROUND: Nur sing car ing and
human car i ng have been studi ed
fr om phi l osophi cal and ethi cal
per specti ves. The tr ansper sonal
car e theor y was devel oped by
Watson (1988) based on this idea.
Leininger (1980) descr ibed car ing as
human acts and pr ocesses that ar e
concer ned with hel ping other s meet
the needs of those r equir ing car e.
PURPOSE: To measur e car i ng
behavior s.
Wol f, Z., Giar dono. E., Osbor ne, P.
and Ambr ose, M. (1994).
Dimensions of nur se car ing. IMAGE:
Jour nal of Nur sing Schol ar ship, 26
(2), 107- 111.
DESCRI TPTI ON: The Car i ng
Behavi or s Inventor y i s a 43- i tem
instr ument. A four point Liker t scal e
is used to el icit r esponses fr om (1)
str ongl y di sagr ee to (4) str ongl y
agr ee on each item.
Car i ng Behav i or s
I nv ent or y ( CBI )
25
DESCRI TPTI ON: The coding steps
ar e: i denti fyi ng the di l emma
components, i denti fyi ng the
consi der ati ons, and categor i zi ng
consider ations. The coding scheme
was then used in a study of mor al
dil emmas r epor ted by a sampl e of
36 i ndi vi dual s (18 mal es & 18
femal es).
Lyons, N. (1982). Conceptions of sel f
and mor al ity and modes of mor al
choice: identifying justice and car e in
j udgments of actual mor al
di l emmas. Unpubl i shed doctor al
di sser tati on. Har var d Uni ver si ty,
Cambr idge.
PURPOSE: Lyons Codi ng Scheme
tests Gi l l i gans hypotheses that
justice and car e ar e distinct modes of
mor al judgment & gender r el ated.
The codi ng scheme al so makes i t
possibl e to examine the r el ationship
between modes of mor al judgment
& modes of sel f- definition.
BACKGROUND: The manual i s
designed for r esear cher s inter ested
in anal yzing mor al dil emma data to
deter mi ne how a per son uses
consider ations of r ights (justice) or
r esponse (car e). The coding method
di sti ngui shes consi der ati ons of
justice and consider ations of car e in
constr ucti on, r esol uti on and
eval uati on of mor al confl i ct and
choice.
Car e and Just i ce
I nt er v i ew
26
RELI ABI LI TY: No i nfor mati on
pr ovided.
VALI DI TY: No i nfor mati on
pr ovided.
BACKGROUND: This questionnair e
concer ns how one copes with str ess
and tension, and how one handl es
str essful situations.
PURPOSE: To assess fr equency and
hel pful ness of speci fi ed copi ng
str ategies.
Jal owi ec, A. (1989). Revi si on &
Testing of the Jal owiec Coping Scal e.
Loyol a Univer sity of Chicago.
DESCRI TPTI ON: Si xty i tem
obj ecti ve questi onnai r es l i st si xty
speci fi c copi ng behavi or s.
Resear cher speci fi es str essor
under investigation by fil l ing in the
bl ank i n i ntr oductor y par agr aph.
Par ticipants indicates r esponses to
each item on two Liker t scal es, fir st
identifying how often they have used
the str ategy, and second, indicating
how hel pful it has been to them.
Jal owi ec Copi ng Scal e
COPI NG ( EB/ Car i ng) 2. 0
27
COPI NG ( EB/ CP) 3. 0
DESCRI TPTI ON: Seventy two
statements depicting var ious ways
of deal i ng wi th ter mi nal i l l nesses
ar e r ated by the r espondents on a 5
item Liker t for mat r anging fr om "not
at al l " to "ver y much". The CSI has
eight components: pr obl em sol ving,
cogni ti ve r estr uctur i ng, expr ess
emotions, social suppor t, pr obl em
avoi dance, wi shful thi nki ng, and
sel f- cr iticism and social withdr awal .
The tool was used in a study of 44
spouses of pati ents admi tted to
Hospice. (Wil l er t, M., Beckwith, B.,
Hol m,J. and Beckwith , S. (1995). A
pr el iminar y study of the impact of
ter mi nal i l l ness of spouses: soci al
suppor t and coping str ategies. The
Hospice Jour nal , 10(4), 35- 48.).
Tobin, D., Hol r oyd, K., Reymol ds, R.
& Wigal , J. (1989). The hier ar chical
factor str uctur e of the Copi ng
Str ategi es Inventor y. Cogni ti ve
Ther apy & Resear ch, 13(4): 343-
361.
pr ovided.
RELI ABI LI TY: The al pha
coefficients for the pr imar y factor s of
the CSI r anged for m .71 to .94.
Tested- r etested r el i abi l i ty
coefficients r anged for .67 to .83.
PURPOSE: The CSI assesses the
extent to which a per son uses cer tain
copi ng thoughts and behavi or s i n
r esponse to a par ticul ar str ess.
BACKGROUND: The for mat of the
CSI adapts 49 items fr om the Ways of
Copi ng checkl i st (Fal kman &
Lazar as, 1980) si xty i tems wer e
gener ated by the author s.
Copi ng St y l es I nv ent or y
( CSI )
28
EMPATHY ( EB/ EM) 4. 0
RELI ABI LI TY: Non- r eactivity of the
empathy categor i es i s demonstr
ated when no significant differ ences
r esul t between subj ects i ni ti al
scor es and scor es 6 and 16 weeks
l ater .
establ ished with input fr om heal th
pr ofessional & thr ough compar ison
of the content of actual nur se -
pati ent i nter acti ons wi th BTIS
si tuati ons. Moder ate suppor t for
constr uct val idity was demonstr ated
when the " content" categor y
cor r el ated positivel y (r = .32 - .51)
wi th fi ve tests. Evi dence for
cr i ter i on- r el ated val i di ty r esul ted
when positive cor r el ations (p< .05)
wer e found between empathy
components of the BTIS, and peer &
super visor r atings of nur ses.
PURPOSE: The BTIS measur es
nur se- expr essed empathy and
consi sts of si tuati ons i nvol vi ng
patients who have been r ol e- pl ayed
and r ecor ded on videotape.
Ol son, J. (1995). Rel ati onshi ps
between nur se- expr essed empa-
thy, patient- per ceived empathy and
patient distr ess. IMAGE, 27(4), 317-
322.
DESCRI TPTI ON: The BTIS pr ovides
a standar dized measur e of ver bal
behavi or i n r esponse to a wi de
var i ety of i nter per sonal si tuati ons
commonl y faced by heal th
pr ofessional s. It contains 13 patient
situations and r equir es 15 minutes
for compl eti on. Scor i ng of the
audiotaped r esponses is based on
BTIS scor ing guidel ines (See Ger ar d,
B. & Buzzel l , M (1980). User
s manual for the behavior al test of
i nter pesonal ski l l s for heal th
pr ocessional s. Reston, VA: Reston.)
The subject is seated in fr ont of a TV
and as the TV pl ays each of the
r ecor ded si tuati ons; the subj ect
makes a
ver bal r esponse to the situation as
though i nter acti ng wi th a r eal
per son. The r esponses ar e
audiotape and then scor ed.
Behav i or Test of
I nt er per sonal Ski l l s
( BTI S)
29
RELI ABI LI TY: Has shown hi gh
l evel s of r el iabil ity (r = .64 - .92).
VALI DI TY: Ni ne studi es have
demonstr ated i nter nal r el i abi l i ty
coefficients consistentl y exceeding
i nter cor r el ati ons among the BLRI
subscal es.
BACKGROUND: See Bar r ett-
Lennar d, G. (1981). The empathy
cycl e: Refi nement of a nucl ear
concept. Jour nal of Counsel i ng
Psychol ogy, 28(2), 99- 91.
PURPOSE: Measur es pati ent-
per ceived empathy.
patient distr ess. IMAGE, 27(4), 317-
322.
DESCRI TPTI ON: The BLRI can be
compl eted in 5 minutes. Consists of
16 statements of either an empathic
or non- empathi c cl i ni ci an. Scor es
r ange fr om 48 to + 48.
Bar r et - Lennar d
Rel at i onshi p I nv ent or y
( BLRI )
30
DESCRI TPTI ON: The ISSB i s a 40
item scal e r ated on a 5 point l iker t
scal e r anging fr om 1 (not at al l ) to 5
(about ever y day).
Bar r er a, M., Sandl er , I and Ramsey,
T. (1981). Pr el iminar y devel opment
of a scal e of soci al suppor ts of
col l ege students. Amer ican Jour nal
of Communi ty Psychol ogy, 9 (4),
435- 447.
VALI DI TY: Indi ces of soci al
networ k size pr oved to be significant
cor r el ates of the ISSB. The ISSB is
positivel y cor r el ated with the Famil y
Envi r onment Scal e (FES) Cohesi on
subscal e.
cor r el ati on coeffi ci ents for
individual items r anged fr om 0.441
to 0.912. r (69) = 0.882, p< 0.001.
Inter nal consi stency (al pha) was
fir st administr ation = 0.926; second
= 0.940.
PURPOSE: The ISSB was devel oped
to eval uate how r espondents
r epor ted the fr equency with which
they wer e the r eci pi ents of
suppor tive actions.
BACKGROUND: Gr owing r esear ch
i nter est i n soci al suppor t
under scor es the need for r el i abl e
and val id measur es of the concept. It
is ar gued that measur es that assess
what individual s actual l y do by way
of pr oviding suppor t make unique
contr ibutions to our under standing
of natur al hel pi ng pr ocesses. See
Bar r er a, M., Sandl er , I.N. & Ramsey,
T.B. (1981). Pr el i mi nar y
devel opment of a scal e of soci al
suppor t: Studies in col l ege students.
Amer i can Jour nal of Communi ty
Psychol ogy, 9(4), 435- 447.
I nv ent or y of Soci al l y
Suppor t i v e Behav i or s
( I SSB)
31
BACKGROUND: The measur e was
devel oped by Car khuff i n
conj uncti on wi th hi s wor k i n
oper ati onal i zi ng conceptual
components of hel pi ng r el ati on-
ships.
PURPOSE: To measur e empathy as
a component of a hel pi ng
r el ationship.
Hender son, M. (1987). Effect of
empathy tr ai ni ng on mor al
r easoning and empathic r esponding
of nur si ng students. Doctor al
disser tation: Aubur n Univer sity.
DESCRI TPTI ON: EUIPASM i s a
fi ve- poi nt scal e of empathi c
under standi ng r efl ected i n the
counsel or s r esponse to hel pee or
cl i ent statements. A l evel - 1
r esponse communi cates no
awar eness of the hel pees feel ings.
A l evel - 2 r esponse shows
awar eness of obvi ous feel i ngs
expr essed by the hel pee. A l evel - 3
r esponse is "accur ate empathy" in
whi ch the expr essi ons of the fi r st
per son ar e i nter changeabl e wi th
those of the seemed per son in that
they expr ess essential l y the same
affect & meani ng. Level - 3 i s
consi der ed the mi ni mal l evel of
empathy necessar y for ther apeutic
change to occur . A l evel 4 r esponse
communi cates accur ate empathy
pl us a deeper l evel of feel i ng. A
l evel - 5 r esponse communicates ful l
awar eness of the hel pees
exper ience, compr ehensive under -
standing of that exper iental r eal ity,
and total acceptance of the per son.
Empat hi c Under st andi ng i n
I nt er per sonal Pr ocesses
( EUI PASM)
32
HUMANI STI C ( EB/ HUM) 5. 0
DESCRI TPTI ON: A l i st of 192
statements descr i bi ng pati ent and
nur sing staff behavior s that occur on
nur si ng uni ts was i ni ti al l y
devel oped. The scal e, consist of 163
items, was devel oped and scor ed in
a 5 point Liker t for mat r anging fr om
1 to 5. The scal e was r educed to 70
i tems measur i ng four di mensi ons:
shar ed deci si on maki ng and
r esponsibil ity, hol istic sel ves, status
equal ity, and empathy.
Fenton, M. (1986). Devel opment of
the scal e of humani sti c nur si ng
behavior s. Nur sing Resear ch, 36(2),
82- 87.
VALI DI TY: Constr uct val idity was
establ ished by a pur posive sampl ing
of 42 nur ses. For the 70 item scal e:
Cr iter ion- Rel ated Val idity: Sig. F (<.
001) for each di mensi on
deter mi ned, addi ti onal test
suppor tive.
RELI ABI LI TY: 1. For 70- item scal e,
subscal e r el iabil ities ar e as fol l ows:
26 i tems, shar ed deci si on
making, al pha = 0.89
25 items, hol istic sel ves, al pha
= 0.88
2 items, status equal ity, al pha =
0.83
7 items, empathy, al pha = .60
2. Test- Retest Rel iabil ity: 0.85;
16 subjects, 2- week inter val .
PURPOSE: Measur es the degr ee of
humanistic heal th car e in hospital
setti ngs as per cei ved by nur si ng
per sonnel .
BACKGROUND: Based on
Howar ds (1975) theor etical model
of di mensi ons per ti nent to the
domai n of humani sti c car e. The
Scal e of Humani sti c Nur si ng
Behavi or s can be used as a
di agnosti c ai d and as an
instr uctional device.
Scal e of Humani st i c
Nur si ng Behav i or s
33
RECI PROCI TY ( EB/ R) 6. 0
RELI ABI LI TY: Al l factor s wer e
shown to be r el iabl e by Cr onbachs
al pha.
establ ished using expl or ator y and
confir mator y factor anal ysis. Initial
constr uct val i di ty was establ i shed
usi ng expl or ator y factor anal ysi s.
The casual model ing appr oach was
used to establ i sh conver gent and
discr iminate val idity.
BACKGROUND: To devel op the
initial item pool , an extensive r eview
of the l iter atur e was conducted. In
addition, inter views wer e conducted
wi th 12 adul ts, the chi l dr en or
in- l aws of el der l y par ents, in their
home envir onments. The inter views
wer e tr anscr ibed and anal yzed. One
hundr ed nine items wer e devel oped
to r efl ect exchanges wi thi n the
car egi ver context and/ or among
fami l y member s di r ectl y or
indir ectl y invol ved in car egiving.
PURPOSE: Measur es the col l ective
expr essi on of exchanges and
bal ance in tr ansactions between the
car egiver and an el der l y patient or
par ent- in- l aw, as wel l as within the
famil y networ k.
Car r uth, A. (1996). Devel opment
and testi ng of the Car egi ver
Reci pr oci ty Scal e. Nur si ng
Resear ch, 45(2), 92- 97.
DESCRI TPTI ON: The CRS i s
constr ucted as a fi ve poi nt Li ker t
for mat r angi ng fr om 1 (str ongl y
disagr ee) to five (str ongl y agr ee).
Car egiver Infor mation Sheet is used
to col l ect data per tai ni ng to
demogr aphic data, il l nesses/ condi-
tions, and exchanges given to and
r eceived fr om car e r ecipr ocity.
Car egi v er Reci pr oci t y
Scal e ( CRS)
34
SELF- DETERMI NI NG ( EB/ SD) 7. 0
DESCRI TPTI ON: The PEA scal e
consi sts of 31 shor t phr ased
questions (8 factor s) scor ed on a 4
point Liker t Scal e r anging fr om 1 =
not at al l tr ue to 4 = compl etel y tr ue.
Scor es r ange fr om 31 - 124 for total
scal e.
Her tz, J. (1991). The Per cei ved
enactment of autonomy scal e:
Measur i ng the Potenti al for
Sel f- Car e Acti on i n the El der l y.
Disser tation: Univer sity of Texas at
Austin.
VALI DI TY: Content & face val idity
establ ished by panel of exper ts and
the pil ot sur vey. Constr uct val idity
obtai ned by testi ng theor eti cal
r el ati onshi ps between PEA &
per ceived contr ol (r = .52, p=<. 001),
and between PEA & mor al e (r = .56,
p<. 001).
RELI ABI LI TY: Cr onbachs al pha
coefficient and pr incipal component
factor anal ysis fol l owed by var imax
or thogonal r otati on wer e used to
i denti fy factor s and i tems for the
final PEA scal e. Cr onbachs al pha =
.87. Rel i abi l i ty establ i shed by
i nter nal consi stency (Cr onbachs
al pha of .85 for the 31 items); as wel l
as content (CVI=. 86).
PURPOSE: Measur es a per sons
per ception of their abil ity to enact
sel f- deter mined behavior .
BACKGROUND: Per cei ved
enactment of autonomy (PEA) i s
sensi ng the abi l i ty to choose
cour se of acti on for ones sel f i n
accor dance with ones goal s to meet
needs for both dependence and
independence. PEA r epr esents the
potenti al for sel f- car e acti on and
conceptual l y l i nks sel f- car e
Per cei v ed Enact ment of
Aut onomy ( PEA Scal e)
knowl edge, r esour ces, and action in
Model i ng and Rol e- Model i ng
(Er ickson, Toml in and Swain, 1988).
35
SELF- DETERMI NI NG ( EB/ SD) 7. 0
RELI ABI LI TY: Inter - i tem
cor r el ation coefficients r anged fr om
0.39 to 0.85. The aver age
cor r el ation between items was 0.64.
Item cor r el ation with the total test
scor e r anged for m 0.69 to 0.89.
Cr onbachs coeffi ci ent al pha was
0.96.
VALI DI TY: Uncer tain. Examination
of i ndi vi dual i tem scor e for m CIS
i ndi cated that, i n some cases, a
di ffer ent standar d of competence
was appl i ed i n r outi ne cl i ni cal
pr acti ce dependi ng upon the
patients tr eatment decision.
BACKGROUND: The i nstr ument
was devel oped fr om initial wor k on
the competency of pati ents to
consent to hospital admission. The
or i gi nal for mul ati on was r evi sed
and extended into the CIS for use
with psychiatr ic patients r efer r ed for
ECT.
PURPOSE: To compar e physicians
judgments of patient competency in
r outine cl inical pr actice with findings
fr om a str uctur ed cl inical inter view.
1) Bean, G., Nishisato, S., Rector , N.
and Gl ancy, G. (1996). The assess
ment of competence to make a
tr eatment decision: An empir ical
appr oach. Canadian Jour nal of
Psychiatr y, 41, 85- 92.
2) Bean, G., Nishisato, S.,
Rector , N. and Gl ancy, G. (1994).
The psychometr ic pr oper ties of the
competency inter view schedul e.
Canadian Jour nal of Psychiatr y,
39, 368- 376.
DESCRI TPTI ON: The CIS i s a
fi fteen- i tem i nstr ument, whi ch
incor por ates 4 major el ements to be
consi der ed when eval uati ng
competency: Abil ity to make a fir m
tr eatment deci si on; under standi ng
of tr eatment infor mation; abil ity to
make a choice based upon r ational
r easons; and, appr eci ati on of the
natur e of the situation. Each el ement
is assessed by a ser ies of questions
r ated on a 7 poi nt Li ker t scal e
r angi ng: 1- 3 = adequate, 4 =
mar ginal , 5- 7 = inadequate.
Compet ency I nt er v i ew
Schedul e ( CI S)
36
BACKGROUND: The i nter vi ew
schedul e was made avail abl e to the
r esear cher by Dr . Car ol Gil l igan. The
r esear cher r evi sed the i nter vi ew
schedul e and used a coding scheme
devel oped by the r esear cher .
PURPOSE: To expl or e the behavior
of nur ses when faced with cl inical
si tuati ons whi ch r equi r ed them to
choose one or mor e behavior s on a
conti nuum of total honesty (ful l y
infor ming cl ients) to ful l y deceiving
cl i ents (uphol di ng the physi ci ans
pl an).
Shi pps, T.B. (1988). Tr uth tel l i ng
behavior of nur ses: what nur ses do
when physi ci ans decei ve cl i ents.
Disser tation: Boston Univer sity.
DESCRI TPTI ON: The i nter vi ew
asks the r espondent to r ecal l a
r eal - l ife dil emma fr om exper ience.
The i nter vi ew pr esents four
hypotheti cal di l emmas: Pl acebo,
Infor med Consent, Negl igence and
Wi thhel d Infor mati on. Tr uthtel l i ng
dil emmas wer e eval uated using the
inter view schedul e.
TRUTHTELLI NG ( EB/ TR) 8. 0
Tr ut ht el l i ng I nt er v i ew
Schedul e
37
DESCRI TPTI ON: Unst r uct ur ed,
open - ended questi ons. Subj ects
wer e asked to descr ibe exampl es of
teachi ng behavi or s they
encounter ed as nur si ng students,
whi ch they consi der ed to be
unethical . The behavior s coul d occur
i n cl assr oom, non- cl assr oom, or
cl inical settings.
Thei s, E. C. (1998). Nur si ng
students per spectives of unethical
teachi ng behavi or s. Jour nal of
Nur sing Education, 27(3), 102- 106.
PURPOSE: To i denti fy nur si ng
students per cepti ons of unethi cal
teaching behavior s.
BACKGROUND: Conceptual l y
based on statements fr om the AAUP
Statement on Pr ofessi onal Ethi cs
whi ch deal s wi th the pr ofessor s
ethical obl igations as a teacher .
UNETHI CAL ( EB/ UETH) 9. 0
Unet hi cal Teachi ng
Behav i or s Tool
38
Et h i c a l Pr o b l e m s
BACKGROUND: The EIS was
devel oped fr om a 32- i tem scal e
used in a 1994 study of Mar yl and
nur ses. The i tems of the or i gi nal
scal e wer e der ived fr om the l iter a-
tur e & focus gr oups inter views of
pr acticing nur ses.
PURPOSE: To measur e the
fr equency by whi ch ethi cal i ssues
occur in nur sing.
Fr y, S. T. & Duffy, M. E. (2001, in
pr ess). Devel opment and
psychometr i c eval uati on of the
Ethi cal Issue Scal e (EIS). Image:
Jour nal of Nur sing Schol ar ship.
DESCRI TPTI ON: Thi r ty two (32)
i tem scal e that r epr esents thr ee
conceptual categor i es of ethi cal
i ssues: end- of- l i fe tr eatments
(n=13), patient car e (n=14), human
r ights (n=5).
Et hi cal I ssue Scal e ( EI S)
RELI ABI LI TY: End - of - l i fe
tr eatment i ssues scal e =. 86
(Cr onbachs al pha coeffi ci ent);
pati ent car e i ssues scal e = .84;
human r i ghts scal e = .74. Can be
used as independent scal es.
VALI DI TY: Confir mator y pr incipal
components anal ysi s of al l i tems
yi el ded a 3- component sol uti on
accounting for a total of 42.4% of
i ni ti al l y extr acted common
var iance.
ETHI CAL I SSUES 1. 0
39
Mor al Pr obl ems
BACKGROUND: Ther e is l ittl e to no
exi sti ng r esear ch about actual
mor al di l emmas faced by nur ses.
Those studies that have been done
have focused on medical ethics, not
speci fi cal l y nur si ng ethi cs. Thi s
deficit in r esear ch was discover ed as
the Nether l ands wor ked to make
nur sing a mor e viabl e and r espected
pr ofession.
PURPOSE: To answer the question:
What i ssues ar e exper i enced as
mor al pr obl ems by nur ses i n
di ffer ent setti ngs and heal thcar e
i nsti tuti ons and how ser i ous ar e
these mor al pr obl ems for them?
Ar end, A. & Hur k, C. (1999). Mor al
pr obl ems among Dutch nur ses: A
sur vey. Nur sing Ethics, 6(6), 468-
82.
DESCRI TPTI ON: It i s a
questionnair e that incl udes sever al
demogr aphi c questi ons and other
infor mation about the r espondent.
The next section contains six types of
pr obl ems that ar e gr aded on
ser iousness on a scal e of 1 to 10. The
l ast two sections consist of a l ist of
situations; fir st the r espondents ar e
asked if these ate situations that they
r ecognize as mor al dil emmas. They
ar e then asked to identify how often
they have exper ienced them.
40
I CU and Et hi cs
RELI ABI LI TY: Sl ightl y skewed
VALI DI TY: Befor e being used this
questionnair e was pil ot tested and
then put befor e a r evi ew boar d
containing nur se ethicists, r esear ch
special ists and doctor al and master s
students.
BACKGROUND: Most of the studies
that have been done on assi sted
sui ci de i n a hospi tal setti ng have
focused on the physicians r ol e, not
that of the nur se.
PURPOSE: To l ear n about bel iefs
and ethi cal concer ns of nur ses
car ing for dying patients in intensive
car e units.
Puntil l o, K., Benner , P., Dr ought, T.,
Dr ew, B., Stotts, N., Stannar d, D.,
Rushton, C., Scanl on, C., & White, S.
(2001). End- of- l i fe i ssues i n
i ntensi ve car e uni ts: A nati onal
r andom sur vey nur ses knowl edge
and bel i efs. Amer i can Jour nal of
Cr itical Car e, 10(4), 216- 29.
DESCRI TPTI ON: Thi s tool i s a
questi onnai r e that contai ns thr ee
secti ons. The fi r st i s a ser i es of
cl inical scenar ios; the r espondents
ar e asked to identify the action taken
by the nur se usi ng one of fi ve
r esponses. They ar e al so asked to
identify whether or not they agr eed
with the action taken. A Liker t scal e
i s used i n the second secti on to
eval uate knowl edge and opi ni on
about pai n management and
end- of- l i fe pr acti ces. The fi nal
section asks for demogr aphics about
the r espondent. Over al l , the
questionnair e contains 61 questions
as wel l as space for addi ti onal
comments.
41
BACKGROUND: The study was a
r epl i cati on and extensi on of
Emanual s 1994 sur vey of New
Engl and oncol ogy physi ci ans. The
study was conducted to pr ovi de
r el iabl e and val id empir ical data to
New Engl and ONS member s
pr acti ces of assi sted sui ci de and
pati ent- r equested euthanasi a.
Anal ysi s focused on nur ses
pr acti ces, a compar i son to a l i ke
sampl e of oncol ogy physicians, and
the nur ses uti l i zati on of the
heal thcar e team.
PURPOSE: To deter mine oncol ogy
nur ses pr acti ces and atti tudes
towar d pati ent r equested
euthanasia and assisted suicide.
Matzo, M. and Emanual , E. (1997).
Oncol ogy nur ses pr acti ces of
assi sted sui ci de and
pati ent- r equested euthanasi a.
Oncol ogy Nur ses For um, 24 (10),
1725- 1732.
DESCRI TPTI ON: Questi onnai r e of
63 questions. Twenty- two questions
i nvol ved four cl i ni cal vi gnettes
r egar di ng per sonal exper i ences
with assisted and patient r equested
euthanasia in cl inical pr actice.
EUTHANASI A/ ASSI STED SUI CI DE ( EP/ EAS) 2. 0
Assi st ed Sui ci de &
Pat i ent Request ed
Eut hanasi a Tool
42
assessed by a panel of exper ts.
BACKGROUND: The i ndi vi dual s
r i ght to r efuse l i fe- pr ol ongi ng
tr eatments was the impetus for the
i ni ti ati on of the Pati ent Sel f-
Deter mi nati on Act (PSDA), whi ch
became effective in 1992. Al though
l iving wil l s have been in existence
for year s, it has onl y been since the
PSDA l egi sl ati on that most nur ses
have had to assume a major r ol e in
col l ecti ng i nfor mati on and
oper ati onal i zi ng advance
dir ectives.
PURPOSE: To deter mi ne nur ses
exper i ence, confi dence i n
counsel ing, and knowl edge of state
l aw concer ning advance dir ectives
(AD).
Bar ta, K. and Neighbor s, M. (1993).
Nur ses knowl edge of and r ol e i n
pati ents end- of- l i fe deci si on-
making. Tr ends in Heal th Car e, Law,
& Ethics, 8 (4), 50- 52.
DESCRI TPTI ON: Thr ee page, four -
par t questionnair e devel oped fr om
l i ter atur e & feder al / state
(Ar kansas) l egisl ation. Par t I: nur ses
exper i ence wi th Ads; Par t II:
Tr ue/ Fal se; nur ses knowl edge of
state l aw content on AD; Par t III:
nur ses incl usion of ANA guidel ines
in nur sing assessments; & Par t IV: 4
point Liker t scal e r anging fr om 1 =
not at al l confi dent to 4 = ver y
confi dent; nur ses per cepti on of
sel f- confi dence r egar di ng
counsel ing patients/ famil ies about
AD.
LI FE SUPPORT ( EP/ LS) 3. 0
Adv ance Di r ect i v e
Quest i onnai r e
43
RELI ABI LI TY: Consi stency of
r esponses r anged fr om 0.772 to
0.947; aver age consi stency was
0.85.
VALI DI TY: Covar i ati on 0.77.
Inter nal consistency for the singl e
factor sol uti on was esti mated at
0.94. The nur ses and one doctor al l y
pr epar ed nur se r esear cher wer e
asked to act as exper t judges and
r eview the r evised vignettes for face
val idity and content sampl ing.
BACKGROUND: The Pati ent Sel f-
Deter mi nati on Act, effecti ve si nce
December , 1991, has changed the
i mpor tance of i ntr oduci ng l i fe
suppor t options to patients. Nur ses,
as pati ent advocates, ar e i n the
for efr ont of pr esenting l ife suppor t
infor mation.
PURPOSE: This tool is designed to
gentl y i ntr oduce the topi c of l i fe
suppor t deci si on maki ng and
opti ons to pati ents. If educates
patients and their famil ies about the
ar r ay of l ife suppor t choices beyond
the NR an mechani cal venti l ati on
options.
Bel and, D. and Fr oman, R. (1995).
Pr el iminar y val idation of a measur e
of l ife suppor t pr efer ences. IMAGE,
27 (4), 307- 310.
DESCRI TPTI ON: The LSPQ i s a
r apid, easy to use instr ument that
pr ovides il l ustr ations of l ife suppor t
choices to enhance discussion of l ife
suppor t measur es with patients. It
consi sts of si x vi gnettes wi th two
choices fol l owing each vignette.
Li f e Suppor t Pr ef er ences
Quest i onnai r e ( LSPQ)
44
BACKGROUND: The PSDA became
effecti ve i n December 1991 and
mandates that pati ents be gi ven
i nfor mati on about l egal r i ghts
r egar ding l iving wil l s and dur abl e
power s of attor ney for heal th car e.
This study investigated the impact of
thi s l aw on hospi tal s, medi cal
per sonnel and pati ents. Despi te
r ecogni ti on of the i mpor tance of
impl ementation of the PSDA, l ittl e is
known about what institutions ar e
actual l y doing.
PURPOSE: Measur es di ffer ent
aspects of the PSDA: (a) hospi tal
per sonnel s devel opment of
awar eness and i nfor mati on-
gather i ng pr ocedur es, (b) the
hospi tal s pr esent pr ocedur es for
i mpl ementi ng the l aw; (c) the
Par k, D., Eaton, R., Lar son, E., and
Pal mer , H. (1994). Impl ementation
and impact of the patient sel f- deter -
mi nati on act. Souther n Medi cal
Jour nal , 87 (10), 971- 977.
DESCRI TPTI ON: The sur vey instr u-
ment consisted of 60 questions that
wer e pr inted in a bookl et and mail ed
to hospital administr ator s. Al l but 17
items wer e for ced choice (tr ue or
fal se).
Sur v ey of I mpl ement at i on
and I mpact of ( PSDA)
i ndi vi dual r espondents per sonal
knowl edge and inter pr etation of the
l aw; (d) the per ceived effect of the
PSDA with r espect to compl etion of
advance dir ectives; and, (e) hospital
per sonnel s attitudes and opinions
about the l aw.
45
RELI ABI LI TY: Test- r est r el iabil ity
was r =. 86 (P <. .01). When identical
for ms wer e admi ni ster ed thr ee
weeks apar t to 35 RNs, Cr onbachs
al pha was .93 (P<< .01).
establ i shed thr ough 100%
agr eement on the content val idity
i ndex by thr ee nur si ng ethi cs
exper ts. Factor s anal ysi s usi ng a
var i max r otati on yi el ded thr ee
theor etical l y meaningful factor s: (1)
acti on r esponse (14 i tems); (2)
aggr essive car e (9 items); and (3)
honesty (8 items). Ther e wer e l ow
significant cor r el ations between the
factor s.
BACKGROUND: Thi s i nstr ument
was used i n the study of mor al
distr ess of cr itical car e nur ses. After
i ni ti al testi ng, the scal e was
extended fr om 5 to 7 poi nts to
i ncr ease var i abi l i ty i n r esponses.
The tool i s based on Jametons
concept of mor al di str ess and
Wil kinsons r esul ts fr om a study of
mor al distr ess.
per cepti ons of l evel of mor al
distr ess and fr equency of situation.
Cor l ey, M. (1993). Mor al distr ess of
cr i ti cal car es nur ses. Amer i can
Jour nal of Cr itical Car e, 4 (4), 280-
285.
DESCRI TPTI ON: The Mor al Distr ess
Scal e is a 32 item scal e scor ed on a 7
point Liker t scal e r anging fr om 1 =
l ow to 7 = high.
MORAL DI STRESS ( EP/ MD) 4. 0
Mor al Di st r ess Scal e
46
RELI ABI LI TY: Resear cher s cl ai m
that " the BQ has acceptabl e
r el iabil ity "Test- r etest r el iabil ity .90
Inter nal consistency of 0.89 for the
entir e scal e and 0.52 to 0.91 for the
sub scal es.
VALI DI TY: Resear cher s cl aim that
"the BQ has acceptabl e val idity" No
fur ther infor mation is pr ovided.
BACKGROUND: The pur pose of this
study was to exami ne concer ns
about r epor ti ng pai n and usi ng
anal gesics in a sampl e of pr imar y
car e gi ver s of cancer pati ents
r ecei vi ng car e fr om a hospi ce
pr ogr am.
PURPOSE: Measur es eight common
bar r ier s to adequate management
of cancer pain.
Ber r y, P. and War d, S. (1995).
Bar r i er s to pai n management i n
hospi ce: a study of fami l y
car egiver s. The Hospice Jour nal , 10
(4), 19- 33.
DESCRI TPTI ON: The BQ is a 27 item
sel f- r epor t instr ument diagnosed to
measur e the extent to which per sons
have eight concer ns about r epor ting
pain and using anal gesics. The 27
items ar e scor ed on a 6 point Liker t
types scal e r anging fr om 0 = do not
agr ee at al l to 5 = agr ee ver y much.
The eight concer ns ar e fear of opiod
si de effects fear of addi cti on. The
bel ief that incr easing pain signifies
di sease pr ogr essi on, fear of
i nj ecti ons, concer n about dr ug
tol er ant, bel ieving "good" patients
do not compl ai n about pai n. The
bel i ef that r epor ti ng pai n may
distr act the physician fr om tr eating
or cur ing the Cancer and fatal ism, or
bel i evi ng pai n i s i nevi tabl e wi th
cancer and that is co not be r el ieved.
PAI N ( EP/ P) 5. 0
The Bar r i er s
Quest i onnai r e ( BQ)
47
of the 15 item pr actice scal e and the
11 item attitudinal scal e was 0.76
and 0.49 r especti vel y. Item total
cor r el ati on wer e r ecal cul ated for
each scal e and items with the l owest
squar ed mul tipl e cor r el ations wer e
del eted. The r evi sed 12 i tem
pr acti ce scal e and 8 i tem atti tude
scal e had a Cr onbachs al pha of
0.78 (standar di zed i tem al pha of
0.82) and 0.63 (standar dized item
al pha of 0.64) r espectivel y.
VALI DI TY: Inter nal consistency of
the 15 item pr actice scal e and the 11
item attitudinal scal e was 0.76 and
0.49 r especti vel y. Item total
cor r el ati on wer e r ecal cul ated for
each scal e and items with the l owest
squar ed mul tipl e cor r el ations wer e
del eted. The r evi sed 12 i tem
pr acti ce scal e and 8 i tem atti tude
scal e had a Cr onbachs al pha of
0.78 (standar di zed i tem al pha of
0.82) and 0.63 (standar dized item
al pha of 0.64) r espectivel y.
BACKGROUND: Speci fi c ai ms: to
descr i be nur ses knowl edge,
pr actice and attitudes about the use
PURPOSE: Identifies issues r el ated
to the use of physical r estr aints with
ol der patients in hospital settings.
Matthiesen, V., Lamb, K., McCann, J.,
Hol l inger - Smith, L. and Wal ton, J.
(1996). Hospital nur ses views about
physi cal r estr ai nt use wi th ol der
patients. Jour nal of Ger ontol ogical
Nur sing, 22 (6), 8- 16.
PHYSI CAL RESTRAI NT USE ( EP/ PR) 6. 0
Rev i sed Rest r ai nt
Quest i onnai r e
of physi cal r estr ai nts i n thi s
popul ati on; and, to deter mi ne
whether demogr aphic char acter is-
tics or the hospital pr actice setting
i nfl uence nur ses knowl edge,
pr actice, attitudes r egar ding the use
of physi cal r estr ai nts wi th ol der
pati ents. Cr oss- secti onal descr i p-
tive study.
DESCRI TPTI ON: 20 item tr ue/ fal se
scal e with 3 subscal es: knowl edge
about physi cal r estr ai nts, cl i ni cal
pr actice issues r el ated to physical
r estr ai nts, atti tudes towar d usi ng
physical r estr aints.
48
PHYSI CAL RESTRAI NT USE ( EP/ PR) 6. 0
Knowl edge and Et hi cs of
Rest r ai nt
RELI ABI LI TY: Twenty- thr ee
nur ses tested the questi ons for
r el evance, r el iabil ity and r epetition.
VALI DI TY: The shor tcomings of this
questionnair e ar e that it onl y deal s
wi th physi cal r estr ai nts and
dementi a pati ents. Ther e i s no
mention of chemical r estr aints or of
non- dementia el der l y. Ther e is al so
no way to know for sur e if what the
nur ses answer ed i s what they
actual l y pr actice.
BACKGROUND: The number of
dementia patients in Isr ael is on the
r ise, as the popul ation gr ows ol der .
This incr ease puts a str ain on nur ses
who ar e not used to deal ing with
such patients. However , ther e has
been l ittl e to no r esear ch done on
physical r estr aint use with dementia
patients.
PURPOSE: To compar e the ethical
dil emmas faced by nur ses in hospi-
tal s and psychoger i atr i c war ds of
nur si ng homes i n usi ng physi cal
r estr ai nts on dementi a pati ents.
Al so, to obtain infor mation about the
knowl edge of nur ses about patients
Weiner , C., Tabak, N. & Ber gman, R.
(2003). The use of physi cal
r estr aints for patients suffer ing fr om
dementi a. Nur si ng Ethi cs, 10(5),
512- 25.
DESCRI TPTI ON: Thi s i s a thr ee-
par t questionnair e. The fir st par t is
demogr aphi c questi ons, i ncl udi ng
l evel of educati on and ger i atr i c
tr aining. The second par t consists of
twenty- five items that test knowl -
edge about the use of r estr aints. An
answer of yes r eceives a scor e of
one, an answer of no or dont
know r eceives a scor e of zer o. The
thi r d secti on i s ei ghteen r eal - l i fe
episodes devised by nur ses in both
settings being tested. The scenar ios
ar e or ganized into thr ee categor ies:
to pr otect the patient, to pr otect the
i nsti tuti on, and to pr otect other
patients at the institution. The sce-
nar ios ar e r ated on a scal e of one to
four as to how appr opr i ate a
r esponse the nur se feel s that
r estr aints ar e.
r ights l aws, the Isr ael i Code of Ethics
and guidel ines on r estr aint.
49
BACKGROUND: Data for the Qual ity
of Life Study wer e obtained thr ough
per sonal i nter vi ews wi th 2,164
per sons, 18 year s & over l iving in
househol ds in the U.S., excl usive of
househol ds on mi l i tar y
r eser vations, in 1971.
PURPOSE: To measur e
r espondents per cepti on to thei r
sol id- psychol ogical condition, their
needs & expectations for l ife, & the
degr ee to whi ch these needs ar e
satisfied.
Campbel l A., Conver se., P.E., &
Rodger s, W.L. (1975). The Qual ity of
Amer i can Li fe. The Insti tute for
Social Resear ch, Sur vey Resear ch
Center , Univer sity of Michigan.
D ESCR I T P T I O N : Se c t i o n a l
Questi onnai r e cover i ng: Ci ty and
nei ghbor hood; housi ng; countr y;
adjectives to descr ibe l ife; education;
empl oyment; or gani zati ons, spar e
ti me and i ncome; fr i endshi ps;
satisfaction with l ife; feel ings about
own l i fe; backgr ound i nfor mati on;
and obser vation of the r espondent
by the inter viewer .
QUALI TY OF LI FE ( EP/ QOL) 7. 0
Qual i t y of Li f e
Quest i onnai r e
50
RELI ABI LI TY: Test- r etest: .97 for
anal ogue scal e and .72 for six point
scal e Cr onbachs coefficient al pha:
.80 for total i nstr ument; .90 for
symptom di str ess and .70 for
activities of dail y l iving.
VALI DI TY: Indir ectl y eval uated due
to subjective feel ings and difficul ty in
inter pr eting their depth; face val idity:
incl udes the items consider ed by the
investigator s and pr evious studies;
content val i di ty establ i shed by
i ncl usi on of i tems i denti fi ed by
i nvesti gator s and suppor ted by
inter views; constr uct val idity needs
to be confi r med thr ough futur e
studies.
BACKGROUND: The need for a
method by whi ch to measur e the
qual i ty of sur vi val (QOL) i s now
i ncr easi ngl y r ecogni zed. Thi s
r efl ects a change on the par t of
member s of the heal th car e team as
the val ue of cancer ther apy is now
judged not onl y on the dur ation of
sur vival but al so on its qual ity.
PURPOSE: To measur e the qual ity
of sur vival fol l owing tr eatment of a
l i fe thr eati ng i l l ness. Speci fi cal l y
measur es sel f- assessment of l i fe
changes that have r esul ted fr om the
pr esence & tr eatment of mal ignant
disease.
Hol mes, S. and Dicker son, J (1987).
The qual i ty of l i fe: desi gn and
eval uati on of a sel f- assessment
i nstr ument for use wi th cancer
pati ents. Inter nati onal Jour nal of
Nur sing Studies, 24, (1), 15- 24.
DESCRI TPTI ON: The questionnair e
contains 11 symptoms statements
and 15 ADLs statements ar r anged in
a l inear anal ogue scal e for mat.
Qual i t y of Li f e Sel f -
Assessment - Cancer
Pat i ent s
51
RELI ABI LI TY: no r el i abi l i ty data
r epor ted.
VALI DI TY: factor anal ysis suggest-
ed constr uct val idity.
BACKGROUND: Devel oped to iden-
ti fy the (a) ter ms that adul ts wi th
chr oni c i l l nesses use to descr i be
thei r qual i ty of l i fe (b) i mpor tant
domains that constitute QOL, and (c)
sel f- per ceived QOL by per sons with
chr onic il l ness.
PURPOSE: Measur es sel f- r epor ted
QOL.
Bur ckhar dt, C., Woods, S. Schul tz, A.
and Ziebar th, D. (1989). Qual ity of
l ife of adul ts with chr onic il l ness: a
psychometr i c study. Resear ch i n
Nur sing and Heal th, 12, 347- 354.
DESCRI TPTI ON: 15 i tem domai n
specific instr ument r ated on a 7 point
Liker t scal e r anging fr om 1 = unhap-
py and ter r i bl e to 7 = del i ghted.
Domains: mater ial comfor ts, heal th,
r el ationships with r el atives, having
& r ear ing chil dr en, cl ose par tner ,
cl ose fr iends, hel ping/ encour aging
other s, or gani zati ons, l ear ni ng,
under standing sel f, wor k, expr ess-
ing sel f cr eativel y, social izing with
other s, r eading, music or watching
enter tainment, and par ticipating in
active r ecr eation.
Qual i t y of Li f e - Adul t s
wi t h Chr oni c I l l nesses 3
52
pr ovided.
pr ovided.
BACKGROUND: The tr eatment of
cancer has r esul ted in an incr eased
awar eness of the need to eval uate
outcome not onl y in ter ms of car e &
sur vival but al so in ter ms of qual ity
of l ife.
PURPOSE: Measur es qual ity of l ife
both i n obj ecti ve and subj ecti ve
ter ms of cancer patients.
Danoff, B., Kr amer , S., Ir win, P. and
Gottl ieb, A. (1983). Assessment of
the qual i ty of l i fe i n l ong- ter m
sur vi vor s after defi ni ti ve
r adiother apy. Amer ican Jour nal of
Cl inical Oncol ogy, 6, 339- 345.
DESCRI TPTI ON: An i nter vi ew
questionnair e was devel oped which
contained both objective as wel l as
subj ecti ve measur es of qual i ty of
l i fe. The questi onnai r e consi sts of
four secti ons: descr i pti ve
demogr aphic items, medical data,
per ceptual qual ity of l ife questions
and heal th status questi ons. The
patient was asked to r ate his feel ings
about each of the 41 QOL items on a
7- point scal e that r anged fr om 1 =
del i ghted to 7 = ter r i bl e. The
per ceptual qual ity of l ife questions
wer e sel ected fr om a ser i es of
national sur veys on qual ity of l ife by
Andr ews & Withey (1976).
Per cept ual Qual i t y of
Li f e I nt er v i ew /
Quest i onnai r e
53
RELI ABI LI TY: Rel iabil ity coefficient
al pha was 0.90 and the
standar dized- item al pha was 0.91.
VALI DI TY: Content vadi ty was
assessed by inter views of patients
wi th l i fe - thr eateni ng i l l ness.
Discr immant Val idity establ ished by
demonstr ated abil ity to distinguish
between situation in which r ecover y
is l ikel y ver ses not l ikel y. Two factor s
wer e confir med by factor anal ysis.
Postine cor r el ation with the Sickness
Impact Pr ofil e, r = 0.89.
BACKGROUND: Social dependence
was defi ned i n ter ms of thr ee
capaci ti es i denti fi ed as necessar y
for the per for mance of an adul t r ol e:
ever yday sel f- car e competence,
mobi l i ty competence, and soci al
competence.
PURPOSE: Measur es extent to
whi ch pati ents r equi r e assi stance
fr om other s in per for ming activities
or r ol es that adul ts or dinar il y can
per for m by themsel ves.
Benol iel , J., McCr okl e, R. and Young,
K. (1980). Devel opment of a Social
Dependency Scal e. Resear ch i n
Nur sing and Heal th, 3, 3- 10.
DESCRI TPTI ON: The i nstr ument
consists of 12, 6 - point scal es (4 for
each capaci ty). Scor es ar e
computed for each capacity (r ange
4- 24) and for al l thr ee capaci ti es
together (r ange 12- 72). Hi gher
scor es r epr esenting a gr eat deal of
soci al dependency and l ower
scor es r epr esenti ng l i ttl e soci al
dependency.
Enf or ced Soci al
Dependency Scal e ( ESDS)
54
RELI ABI LI TY: Inter r ater and
intr ar ater r el iabil ity was examined
usi ng r epeated measur es ANOVA;
inter r ater r el iabil ity was l ower than
i ntr a r ater r el i abi l i ty. Inter nal
consistency: over al l al pha was 0.80.
VALI DI TY: Constr uct val idity wer e
examined using a t- - test for the two
a pr i or i hypotheses: p = 0.04:
Concur r ent val idity was cor r el ated
to be statistical l y significant with the
Spitzer index.
BACKGROUND: Qual i ty of l i fe
assessment has been suggested as
the best method for deter mining the
effectiveness of var ious appr oaches
to pal l iative car e.
PURPOSE: Measur es qual ity of l ife.
Ster kenbur g, C., Ki ng, B., and
Woodwar d, C. (1996). A r el iabil ity
and val idity study of the McMaster
Qual ity of Life Scal e (MQLS) for a
pal l i ati ve popul ati on. Jour nal of
Pal l iative Car e, 12 (1), 18- 25.
DESCRI TPTI ON: The McMaster
Qual i ty of Li fe Scal e taps four
di mensi ons of qual i ty of l i fe:
physi cal , emoti onal , soci al and
spir itual . It contains 32 items r ated
on a 7 point numer ical scal e r anging
fr om negative descr iptor s to positive
descr iptor s.
McMast er Qual i t y of Li f e
Scal e( MQLS)
55
PURPOSE: To measur e outcomes of
contact with the heal th car e del iver y
system; al so, to measur e heal th
status based on functioning.
RELI ABI LI TY: The SIPS test- r etest
r el iabil ity was r epor ted by Pol l ar d
and associates (1976). After a 24-
hour i nter val , the cor r el ati on
between the test- r etest si tuati on
was .88 (p< .01). Sever al other
combi nati ons of teat- r etest
pr ocedur es wer e under taken (e.g.,
l ong for m ver sus shor t for m;
i nter vi ews admi ni ster ed ver sus
sel f- administer ed); al l combinations
of these di ffer ent condi ti ons had
cor r el ations that wer e significant at
p< .01. In addi ti on, test- r etest
r el iabil ity cor r el ation for each of the
12 di mensi ons ar e of the same
magnitude of significance.
VALI DI TY: The i tem pool was
sel ected fr om r esponses by " over
1000" per sons who menti oned
1.250 speci fi c dysfuncti ons of
behavi or al changes that wer e
r el ated to heal th (Gil son et al ., 1975.
p. 1307). By var ious gr ouping and
testi ng pr ocedur es, thi s l i st was
r educed to the cur r ent number of
items. Var ious exper iments r el ated
to the val idity of the instr ument wer e
r epor ted by Ber gner , Bobbi tt,
BACKGROUND: Al though the need
for a method of measur i ng the
qual ity of l ife of patients under going
ther apy for cancer has been widel y
r ecogni zed, no adequatel y
eval uated or feasibl e method has
been establ ished. Thus the SIP was
devel oped as an outcome measur e
of over al l heal th as a consequence
of the use of the heal thcar e
del iver y system.
Si ckness I mpact Pr of i l e
( SI P)
Pol l ar d, Mar tin and Gil son (1976).
The successful (p< .001) tests of
val i di ty i ndi cated that the SIP
per centage scor e cor r el ates wi th
sel f- assessment of sickness (r = .54),
sel f- assessment of dysfunction (r =
.52); the Acti vi ti es of Dai l y Li vi ng
Index (Spear man r ank- or der
cor r el ati on = .46), a cl i ni cal
assessment of dysfunction (r = .49)
and the activity l imitation question
i on the Nati onal Heal th Inter vi ew
Sur vey (r = .61).
56
Si ckness I mpact Pr of i l e
( SI P)
DESCRI TPTI ON: The Si ckness
Impact Pr ofi l e contai ns 136 i tems
gr ouped into 12 dimensions of dail y
activity; sl eep and r est, emotional
behavior , body car e & movement,
home management, mobil ity, social
i nter acti on, ambul ati on, al er tness
behavi or communi cati on, wor k,
r ecr eation & pastimes, and eating.
Respondents check those items that
appl y to them at the ti me of the
inter view.
Sel by, P., Chapman, A.,
Etazadi - Amol i , J., Dal l ey, D. and
Boyd, N. (1984). The devel opment of
a method for assessing the qual ity of
l ife of cancer patients. Br itish Jour nal
of Cancer , 50, 13- 22.
57
r el iabil ity: r = 0.60
Inter nal consi stency: Cr onbachs
al pha: total = 0.82; sub scal es:
symptoms = 0.63; social concer ns =
0.68; psychol ogi cal wel l - bei ng =
0.62; and, physi cal wel l - bei ng =
0.72.
VALI DI TY: Constr uct val i di ty: F =
36,1; p = 0.001
Content val idity: CVI = 0.90
Constr uct val idity: 9 factor s via factor
anal ysis.
BACKGROUND: The tool is model ed
after the QOL instr ument tested by
Padil l a & Gr ant (1985) & Padil l a, et.
Al . (1983).
PURPOSE: Measur es qual ity of l ife.
Fer r el l , B., Wi sdom, C., Wenzl , C.
and Br own, J. (1989). Effects of
contr ol l ed r el ease mor phi ne on
qual i ty of l i fe for cancer pati ents.
Oncol ogy Nur si ng For um, 16 (4),
521- 526.
DESCRI TPTI ON: The Qual ity of Life
sur vey i s a mul ti di mensi onal 100
mm anal ogue scal e wi th wor d
extr emes as anchor s at the end of
each scal e. Items for the 28- item
sur vey r epr esented the ar eas of
psychol ogical wel l being, physical
wel l bei ng, gener al symptom
contr ol , speci fi c symptom contr ol ,
and social suppor t.
Qual i t y of l i f e Sur v ey
( QLS)
58
RELI ABI LI TY: Repor ted in: Kapl an,
R.M. & Ander son, J. P. (1988). The
qual i ty of wel l - bei ng scal e!
Rational e for a singl e qual ity of l ife
index. In Wal kee, S. R. & Rosser , R.
(EDS). Qual i ty of Li fe: Assessment
and Appl i cati on, London, MTP
PRESS, p.p. 51- 77.
VALI DI TY: See above.
BACKGROUND: QWB scor es ar e
der ived fr om pr efer ence weight s for
combinations of symptom/ pr obl em
compl exes and cl assi fi cati on of
functi oni ng i n ter ms of mobi l i ty,
physical activity, and social activity
obtained for m a San Diego gener al
popul ation sampl e of 867 individu-
al s. These pr efer ence weights wer e
obtained in the mid 1970s but a 1991
study of Or egon ci ti zens yi el ded
ver y simil ar r esul ts.
PURPOSE: To pr ovide an estimate
of the val ue of heal th status
Hays, R., Siu, A., Keel er , E., Mar shal l ,
G., Kapl an, R., Si mmons, S., El
Mouchi, D. and Schnel l e, J. (1996).
Long ter m car e r esi dents
pr efer ences on the QWB scal e.
Medi cal Deci si on- Maki ng, 16 (3),
254- 261.
DESCRI TPTI ON: The QWB Scal e
identifies a heal th r el ated symptom
that is most undesir abl e and gr ades
it by the degr ee to which it affects
ever yday activities. By using QWB
assessment, a si ngl e number i s
devel oped that r epr esents the
cur r ent impact of disease.
Qual i t y of Wel l Bei ng
Scal e ( QWB)
necessar y for cost- util ity anal yses.
Al so, to quanti fy heal th- r el ated
qual ity of l ife with a singl e number
that r epr esents communi ty- based
pr efer ences for combi nati ons of
symptom/ pr obl em compl exes,
mobil ity, physical activity, and social
activity.
59
RELI ABI LI TY: Inter nal Consistency
(Cr onbachs al pha) = 0.93 for the
total scal e and 0.87, 0.82, 0.90 and
0.77 for the sub scal es.
suppor ted by the contr asted gr oups
appr oach and factor anal ysi s.
Conver gent val i di ty was pr ovi ded
by a cor r el ation of r = 0.77 between
the QLI and an assessment of l ife
satisfaction.
BACKGROUND: The i nstr ument
was devel oped to pr ovi de
i nfor mati on about speci fi c l i fe
domai ns i n or der to al l ow heal th
car e pr ofessi onal s to pi n poi nt
pr obl em ar eas, examine pr actices,
and pl an inter ventions to impr ove
qual ity of l ife.
PURPOSE: Measur es subj ecti ve
sati sfacti on i n wi th speci fi c l i fe
domains; measur es impor tance of
domains to the subject.
Fer r ans, C. and Power s, M. (1992).
Psychometr ic assessment of qual ity
of l i fe i ndex. Resear ch i n Nur si ng
and Heal th, 15, 29- 38.
DESCRI TPTI ON: Tool consists of 64
i tems, 2 par ts: Par t I: measur es
satisfaction with var ious domains of
l ife on a 6 point Liker t scal e r anging
fr om 1 = ver y satisfied to 6 = ver y
di ssati sfi ed; Par t II: measur es
impor tance of the same domains to
the i ndi vi dual on a 6 poi nt Li ker t
scal e r angi ng fr om 1 = ver y
unimpor tant to 6 = ver y impor tant.
The domai ns of l i fe measur ed
incl ude, (1) heal th and functioning,
(2) Soci ol economi c status. (3)
Psychol ogical / spir itual status, and
(4) famil y r el ationships.
Qual i t y of Li f e I ndex
( QLI )
60
RELI ABI LI TY: Rel iabil ity coefficient
= 0.82143
Al pha coefficient = 0.82557.
VALI DI TY: Cor r el ations wer e found
to be positive.
PURPOSE: Measur es symptom
distr ess of patients.
McCor kl e, R. and Young, K. (1978).
Devel opment of a symptom distr ess
scal e. Cancer Nur sing, 373- 378.
DESCRI TPTI ON: Ten symptoms
ar e eval uated (nausea, appetite,
pai n, fati gue, bowel patter ns,
concentr ati on, appear ance,
br eathing, outl ook, & cough). Five
by seven car ds wi th a si ngl e
symptom wer e pr epar ed. Patients
r ated their symptoms on a given day
fr om 1 (l east di str ess) to 5 (most
distr ess) on the car ds.
Sy mpt om Di st r ess Scal e
61
al phas for QOL - CA r ange fr om .52
to .88 total al pha is 0.91.
VALI DI TY: Constr uct val i di ty &
conver gent constr uct val i di ty i s
establ ished. Factor anal ysis yiel ded
5 factor s.
BACKGROUND: The mul ti -
dimensional qual ity of l ife scal e for
use wi th per sons wi th cancer
evol ved for m a need for a singl e,
shor t, easy to administer , r el iabl e
and val id, gr aphic measur e of wel l
being in per sons with cancer . QOL;
was or i gi nal l y defi ned as a
per sonal , subjective e val uation of
physi cal and psychol ogi cal wel l
being and symptom distr ess.
PURPOSE: To measur e the qual ity
of l ife of cancer patients.
Padil l a, G., Pr esant, C., Gr ant, M.,
Metter , G., Lipsett, J. and Heide, F.
(1983). Qual i ty of l i fe i ndex for
pati ents wi th cancer . Resear ch i n
Nur si ng and Heal th, 6, 117- 126.,
al so Padil l a, G. V., Miskel , M H., &
Gr ant, M. M. (1992). Ur tai nty,
appr aisal , and qual ity of l ife. Qual ity
of Life Resear ch, 1(3), 155- 165.
DESCRI TPTI ON: In the or i gi nal
tool , QOL was measur ed on 14
l inear anal ogue scal e items scor ed
fr om 0 - 100 in incr ements of 10.
Aver age QOL scor e i s 14. Items
assess physi cal condi ti on, nor mal
activities, and per sonal attitudes on
gener al qual ity of l ife. I n the QOL -
CA tool , QOL i s measur ed by 30
times that assess (1) psychol ogical
exi stenti al wel l - bei ng, (2)
physi cal / functi ons wel l - bei ng, (3)
symptoms distr ess & nutr itum, (4)
symptom di str ess & pai n/ bowel
patter n, and (%) attitude of wor r y.
Qual i t y of Li f e Cancer
Scal e ( QOV- CA)
62
RELI ABI LI TY: Rel i abi l i ty
coeffi ci ents r anged fr om 0.81 to
0.88 for the mul ti - i tem scal e.
Inter nal consi stency r el i abi l i ti es
wer e l ower that the ful l l ength
ver sions: heal th per ception subscal e
= 0.87 (0.88 for 9 i tem ver si on);
mental heal th measur e subscal e =
0.88 (0.96 for the 38 item ver sion);
physi cal functi on subscal e = 0.86
(0.90 for the 10 item ver sion); r ol e
subscal e = 0.81 (0.92 for the 3 item
ver sion).
VALI DI TY: Al l cor r el ati ons wer e
statistical l y significant: p < 0.01 and
most wer e substantial in magnitude
BACKGROUND: Resear ch showed
that the McMaster Heal th Index,
Sickness Impact Pr ofil e, Functional
Status Questi onnai r e, Duck- UNC
Heal th Pr ofi l e, RAND Heal th
Exper i ence Measur es, Notti ngham
Heal th Pr ofi l e and Index of Wel l
Being wer e instr uments too l ong to
PURPOSE: To measur e gener al
heal th concepts for use in eval uating
heal th car e.
Stewar t A., Hays, R. and War e, J.
(1988). The MOS Shor t For m Gener al
Heal th Sur vey. Medical Car e, 26 (7),
724- 732.
DESCRI TPTI ON: The MOS- Shor t
for m is a 20- item scal e. Items ar e
scor ed on a 5 point Liker t Scal e.
MOS Shor t For m
be pr actical in most cl inical settings.
Thus, a compr omi se between
l engthy instr uments and singl e- item
measur es was sought. Twenty items
wer e sel ected to r epr esents si x
heal th concepts: (1) physi cal
functioning, (2) r ol e functioning, (3)
social functioning, (4) mental heal th,
(5) heal th Per ceptions, and (6) pain.
63
Mo r a l Re a so n i n g
BACKGROUND: Based on pr i or
wor k by Ajzen and Fishbeins theor y
of r easoned action.
DESCRI TPTI ON: Thr ee par t fi xed
r esponse questionnair e: Par t I: items
ascer tai n nur ses awar eness of
hospi tal DNR pol i cy, exper i ences
wi th DNR si tuati ons and bel i efs
about who shoul d make DNR
deci si ons; Par t II: tests nur ses
atti tudes, subj ecti ve nor ms and
behavi or al i ntenti ons towar d
compl i ance usi ng hypotheti cal
situations and scal e r esponses; Par t
III: col l ects demogr aphic data.
Savage, T.A., Cul l en, D.L., Kir choff,
K.T., Pugh, E.J. & For eman, M.D.
(1987). Nur ses r esponses to
do- not- r esusci tate or der s i n the
neonatal intensive car e unit. Nur sing
Resear ch, 36, 370- 373.
PURPOSE: El icits nur ses attitudes,
subj ecti ve nor ms and behavi or al
intent with r espect to DNR or der s in
neonatal intensive car e units.
GENERAL ( MR/ G) 1. 0
Responses t o DNR or der s
i n t he NI CU
64
RELI ABI LI TY: Cr onbachs al pha is
i n the upper .70s/ l ow .80s.
Test - r etest is about the same.
VALI DI TY: Has been assessed
in ter ms of seven cr iter ia over
fi fteen year s. DIT scor es show
di scr i mi nant val i di ty fr om ver bal
abi l i ty/ gener al i ntel l i gence and
fr om conser vative/ l iber al pol itical
attitudes.
BACKGROUND: The DIT i s a
mul ti pl e - choi ce, obj ecti ve, and
sel f- admi ni ster ed test der i ved
for m Kohl ber gs Theor y of mor al
devel opment. It has been
extensi vel y tested and i s now
avail abl e in a new ver sion, DIT - 2.
PURPOSE: Measur es how peopl e
r eason mor al l y about soci al
pr obl ems.
DESCRI TPTI ON: DIT - 1 contains
si x vi gnettes fol l owed by
mul ti pl e choi ce questi ons
addr essing r ecommended action
and pr ior itization of items. DIT -
2 consists of five dil emmas that
r epr esent moder n social pr obl ems.
The DIT - 1 Shor t for m consists of
just the fir st thr ee dil emmas of
the DIT - 1.
Rest, J., Nar vaez, D., Bebeau, M. J.
& Thomas, S. J. (1998).
Postconventional mor al Thinking:
A Neo- kohl ber gian Appr oach.
Def i ni ng I ssues Test
( DI T- 1 A & DI T- 2)
65
VALI DI TY: Si gni fi cant di ffer ences
demonstr ated among nur ses wi th
differ ent educational pr epar ation in
pr i nci pl ed nur si ng consi der ati ons
(F= 3.37, p < .001). Wher e those with
higher education scor ed higher and
those wi th l ower . Ther e i s a
significant cor r el ation between the
DiT and NDT (p < .001).
BACKGROUND: Uses the DIT as its
par adigm and measur es a cognitive
pr ocess, mor al judgment.
RELI ABI LI TY: Coeffi ci ent al pha =
.57 for pr i nci pl ed mi ssi ng
consider ation.
DESCRI TPTI ON: Tool contains six
vi gnettes, each fol l owed by thr ee
secti ons of obj ecti ve questi ons
asking par ticipant to indicate what
she/ he woul d do in the situation, to
r ank six statements about r el evant
issues fr om most to l east impor tant,
and to r ate the extent of her / hi s
pr evious invol vement with simil ar
dil emmas.
Cr i sham, P. (1979). Measur i ng
mor al j udgment i n nur si ng
dil emmas: Nur sing Resear ch, 30(2),
104- 110.
PURPOSE: Measur es mor al
r easoning in nur sing situations.
GENERAL ( MR/ G) 1.0
Nur si ng Di l emma Test
( NDT)
66
RELI ABI LI TY: Poi nt bi ser i al for
each of the items was .40 or above.
Haytis r el iabil ity with the total test
(RH)= .93.
VALI DI TY: Content val i di ty
deter mined by exper ts.
BACKGROUND: Based on
Cr i shams scenar i os that wer e
not incl uded in the NDT.
PURPOSE: Measur es nur ses sel f-
r epor ted behavior s.
DESCRI TPTI ON: Si x pati ent car e
vi gnettes fol l owed by mul ti pl e
choices questions with one choice
congr uent wi th the ANA Code
for Nur ses.
Cox, J. L. (1985/ 1986). Ethi cal
deci si on maki ng by hospi tal
nur ses. (Doctor al Di sser tati on,
Wayne State Univer sity) Disser tation
Abstr acts Inter national , 47, 131B.
Et hi cal Behav i or
I nv ent or y
67
BACKGROUND: Cl ient advocacy is
an essenti al component of the
pr ofessi onal r ol e of the nur se,
al though r el ati vel y l i ttl e i s known
about how this impor tant concept is
viewed by the aver age nur se.
DESCRI TPTI ON: The advocacy
assessment questionnair e consists
of thr ee par ts: Par t I: or der r ank
the thr ee model s of advocacy and
indicate on a Liker t- scal e the degr ee
of agr eement or di sagr eement
with the kind of advocacy. Par t II:
sel ect and r ank the thr ee most
favor ed and l east favor ed
r esponses to a wr i tten mor al
di l emma. Par t III: Demogr aphi c
infor mation.
Mi l l ete, B.(1993). Cl i ent advocacy
and the Mor al or ientation of nur ses.
Wester n Jour nal of Nur si ng
Resear ch,15(5), 607- 618.
PURPOSE: Thi s tool measur es
model s of advocacy used in nur ses
ethical decisions.
Adv ocacy Assessment
Tool
68
RELI ABI LI TY: Not r epor ted.
VALI DI TY: Not r epor ted.
BACKGROUND: The questionnair e
is adapted fr om one used in a
study of physi ci ans, the r esul ts
of whi ch ar e r epor ted by Sel f i n
1983.
PURPOSE: To deter mi ne the
phi l osophi cal posi ti ons hel d by
nur ses wi th r espect to thei r
ethi cal deci si ons, and thei r
r el ati onshi p to the subj ecti ve-
obj ecti on contr over sy i n Val ue
Theor y.
DESCRI TPTI ON: The " nur se-
ver sion" of the tool is 9 questions.
The questi ons ar e constr ucted
so that thr ee questi ons r el ate to
each of thr ee possibl e positions in
the subj ecti ve- obj ecti ve i ssue;
i .e., subj ecti vi sm, par ti al -
subj ecti vi sm- par ti al obj ecti vi sm,
and compl ete objectivism.
Sel f, Donnie J. (1987). A study of the
foundati on of ethi cal deci si on-
maki ng of nur ses. Theor eti cal
Medicine, 8: 85- 95.
HEALTH CARE ( MR/ HC) 2. 0
Heal t h Car e Deci si on -
Maki ng Quest i onnai r e
( Nur ses Ver si on)
69
VALI DI TY: Cor r el ati on between
the two scal es for pati ents = .58,
and for fami l y sampl e = .64
("moder atel y high").
BACKGROUND: Resear cher s used
four ethical pr incipl es as the basis
for val ues that woul d be hel d by
patients & patients famil ies.
RELI ABI LI TY: Al pha r el i abi l i ty =
patient sampl e: .69, dyad sampl e:
.76.
DESCRI TPTI ON: Si xteen i tems
i nventor y, l ater r efi ned to 12
i tems. 2 subscal es: autonomy
and benefi cence. Items use
Liker t scal e, 1 = str ongl y disagr ee,
4 = str ongl y agr ee. Instr ument
administer ed 4th - 6th postoper a-
tive day.
Gor tner , S. & Zyzanski, S. (1988).
Val ues in the choice of tr eatment:
Repl ication and r efinement. Nur sing
Resear ch, 37, 240- 244.
PURPOSE: To measur e patients &
fami l y val ues i n the choi ce of
tr eatment, par ti cul ar l y i n sur gi cal
tr eatment of car diac disease.
PRI NCI PLED ETHI CS ( MR/ PE) 3. 0
Val ues i n t he Choi ce of
Tr eat ment I nv ent or y
70
BACKGROUND: In the ter mi nal
phase of l ife, some cancer patients
have pr obl ems eating. Car egiver s
then have to deci de whether or
not to pr ovide the patients with food
by ar ti fi ci al means. Taped
i nter vi ews concer ni ng tr eatment
of ter mi nal l y i l l , mental l y al er t,
ol d cancer pati ents who r efused
food wer e conducted with 20 RNs
who wer e r egar ded as "exper ienced
and good nur ses."
PURPOSE: Identi fi es ethi cal
r easoning in exper ienced r egister ed
nur ses by an anal ysi s of the
conditions under which they think
that ter mi nal l y i l l , mental l y al er t,
ol d cancer patients who r efuse food
shoul d be fed, whether they think
active euthanasia shoul d be used,
how they expl ai n thei r deci si on,
DESCRI TPTI ON: The i nter vi ewer
asks the r espondent their opinion on
active euthanasia. The r espondent
r anks in or der the ethical pr incipl es
of autonomy, beneficence, justice,
and sancti ty of l i fe for her
pr ofessi onal as wel l as for her
per sonal l i fe, and expl ai ns how
the r anking was deter mined.
Jansson, L. & Nor ber g, A. (1989).
Ethi cal r easoni ng concer ni ng the
feedi ng of ter mi nal l y i l l cancer
patients: Inter views with r egister ed
nur ses exper i enced i n the car e
of cancer patients. Cancer Nur sing,
12, 352- 358.
PRI NCI PLED ETHI CS ( MR/ PE) 3. 0
Et hi cal Reasoni ng i n
Ter mi nal Car e I nt er v i ew
and how they woul d r ank or der
ethical pr incipl es and expl ain their
r anking.
71
BACKGROUND: The SRM is a paper
and penci l wr i tten ver si on of the
or iginal mor al Judgment Inter view
(MJI) of Kohl ber g.
DESCRI TPTI ON: The SRM uses
the same di l emi nas as the MJI
but i nvol ves wr i tten r esponses
r ather than one- on- one or al tape-
r ecor ded r esponses. The SRM
is gr oup administr abl e.
Gibbs, J. and Widaman, K. (1982).
Soci al Intel l i gence: Measur i ng the
Devel opment of Soci omor al
Refl ection, 191- 211. Pr entice- Hal l :
NJ.
r easoning.
SOCI OMORAL REASONI NG ( MR/ SM) 4 . 0
Soci al Ref l ect i on Measur e
( SRM)
72
RELI ABI LI TY:High al ter native for m
r el iabil ity of up to 100% agr eement
on stage scor e has been r epor ted.
VALI DI TY: Subj ects measur ed
over time mor e for war d thr ough the
hypothesi zed stages of mor al
r easoning in an invar iant sequence,
suppor ti ng the constr uct of a
devel op mental sequence of mor al
r easoning.
BACKGROUND: The MJI was the
or iginal test devel oped by Kohl ber g
to measur e the mor al r easoni ng
constr uct, and r efl ects hi s
conceptual i zati on of j usti ce as
the centr al cor e of mor al i ty.
Ther e ar e thr ee for ms of the MJI,
each consisting of thr ee dil emmas.
PURPOSE: To eval uate the mor al
j udgment of per sons usi ng
dil emmas.
DESCRI TPTI ON: The MJI consi sts
of a 45- mi nute semi str uctur ed
or al tape- r ecor ded i nter vi ew
i n whi ch subj ects ar e asked
to r esol ve a ser i es of thr ee
mor al dil emmas. Each dil emma is
fol l owed by a systemati c set
of open- ended pr obe questi ons
desi gned to enabl e the subj ect
to r eveal the str uctur e of l ogi c of
his or her r esponses. Scor ing yiel ds
an over al l scor e, whi ch i s a
conti nuous measur e of mor al
matur ity; and a scor e that r efl ects
the subj ects stage of mor al
r easoning.
Kohl ber g, L. (1984). The psychol ogy
of mor al devel opment. Essays i n
Mor al Devel opment, II. Har per and
Row: San Fr ancisco.
SOCI OMORAL REASONI NG ( MR/ SM) 4. 0
Mor al Judgment
I nt er v i ew : Kohl ber g
( MJI )
73
Va l u e s a n d At t i t u d e s
Neimeyer , R., Epting, F. and Rigdon,
M. (1984). A pr ocedur al manual
for the Thr eat Index.
Neimeyer , R., Fontana, D. and Gol d,
K. (1984) A manual for content
anal ysi s of death constr ucts. both
In, F. Eptin, g and R. Neimeyer (eds.),
Per sonal Meanings of Death, 299-
327. WA: Hemi spher e Publ i shi ng
Company.
DESCRI TPTI ON: Str uctur ed 90
mi nute i nter vi ew; i ndi vi dual l y
administer ed. 9 situations ar e used
i nvol vi ng death. The i nter vi ewee
i s pr ovi ded wi th 3 " death" car ds
wi th the si tuati ons on them and
is questioned as to their simil ar ities
and differ ences.
RELI ABI LI TY: Codi ng system
j udged r el i abl e usi ng two
independent judges.
VALI DI TY: Not addr essed.
BACKGROUND: Thi s tool was
devel oped to enabl e the content
anal ysis of death r el ated constr ucts
as apposed to tool s that measur e
the str uctur e of el ements wi thi n
the constr uct.
PURPOSE: Pr ovi des cl i ni cal l y r i ch
and per sonal l y r el evant depi cti on
of inter viewees constr ual of death;
may faci l i tate psychother apeuti c
expl or ati on of cl i ents death
concer n. The manual detai l s
the system for anal yzi ng the
content of constr ucts that
per sons empl oy to conceptual i ze
si tuati ons i nvol vi ng death and
dying.
DEATH ( V/ A/ D) 1. 0
Th r ea t I n d ex - el i ci t ed
f or m ( TI E)
74
devel oped to enabl e the content
anal ysis of death r el ated constr ucts
as apposed to tool s that measur e
the str uctur e of el ements wi thi n
the constr uct.
Neimeyer , R., Epting, F. and Rigdon,
M. (1984). A pr ocedur al manual
for the Thr eat Index. In, F. Epti ng
and R. Nei meyer (eds.), Per sonal
Meani ngs of Death, 321- 327.
WA: Hemi spher e Publ i shi ng
Company.
DESCRI TPTI ON: 30 or 40 questions
that i nvesti gate 3 el ements:
sel f, pr efer r ed sel f and death. A
7- poi nt scal e i s used to scor e
r esponses. Scor es on ei ther
actual i zati on or i ntegr ati on
can r ange fr om 0 to 40.
PURPOSE: Standar di zed for m
of the Thr eat Index. Pr ovi des
40 bi pol ar di mensi ons on whi ch
the r espondent r ates "sel f", "ideal
sel f" and " own death" thi nki ng
about the l atter as i f i t wer e
per sonal l y imminent.
DEATH ( V/ A/ D) 1. 0
Thr eat I ndex- Pr ov i ded
f or ms ( Ti p40)
75
Robinson, P. and Wood, K. (1984).
Fear of death and physical il l ness:
a per sonal constr uct appr oach. In,
F. Epti ng and R. Nei meyer (eds.),
Per sonal Meani ngs of Death,
213- 228. WA: Hemi spher e
Publ ishing Company.
DESCRI TPTI ON: 15 questi ons
tr ue/ fal se questionnair e.
r el iabil ity = .83 inter nal consistency
coefficient =.76.
VALI DI TY: Suppor ted by studi es
of psychiatr ic patients and col l ege
students. Hi gh cor r el ati on
coeffi ci ent (.74) between the
DAS and a simil ar tool (FODS).
BACKGROUND: The DAS was
devel oped to r efl ect a wider r ange
of l i fe exper i ences than i n other
tool s that measur e death fear /
anxiety.
PURPOSE: El i ci ts emoti onal
r eactions to death and dying.
DEATH ( V/ A/ D) 1. 0
Temp l er Dea t h An x i et y
Scal e ( DAS)
76
DEATH ( V/ A/ D) 1. 0
Col l ett, L., & Lester , D. (1969). The
fear of death and the fear of dying.
Jour nal of Psychol ogy, 72, 179- 181.
answer ed on a 6 point Liker t scal e
with the higher scor e indicative of an
endor sement of the fear - indicating
items.
Col l et - Lest er Fear of
Deat h Scal e ( FDS)
VALI DI TY: Suppor ted by l ow
cor r el ati ons between four
subscal es.
di sti ngui sh between the fear of
death & the fear of the pr ocess of
dyi ng and to di ffer enti ate these
fear s for one sel f and for another
per son.
PURPOSE: Assesses over al l fear of
death and dyi ng as wel l as four
separ ate fear s: fear of death of sel f;
fear of death of other ; fear of dying of
sel f; fear of dying of other .
77
Mor r i son, R., Mor r i son, E. and
Gl i ckman, D. (1994). Physi ci an
r el uctance to di scuss advance
di r ecti ves. Ar chi ves of Inter nal
Medicine, 154, 2311- 2318.
DESCRI TPTI ON : Ph y si ci a n s
attitudes towar d advance dir ectives
ar e assessed by their 14 r esponses
to statements. For physicians who
had exper i enced wi th advance
dir ectives, five additional questions
assess the type and extent of their
i nvol vement. Al l r esponses ar e
assessed on a fi ve- poi nt Li cker t
Scal e.
BACKGROUND: The tool is r epor ted
i n Davi dsen, K. W., Hackl er , C.,
Car adi ne, D. R. & McCor d, M. D.
(1998). Physi ci ans atti tudes on
advance di r ecti ves, JAMA, 262,
2415- 2419.
PURPOSE: Measur es physi ci ans
attitudes towar d advance dir ectives.
GENERAL ( V/ A/ G) 2. 0
At t i t udes Tow ar d
Adv ance Di r ect i v es
78
RELI ABI LI TY: establ i shed by two
anal ysis techniques.
VALI DI TY: establ i shed by two
anal ysis techniques.
BACKGROUND: The pr esent study
was an attempt to focus on the views
of nur ses r egar ding dependence vs.
independence for both nur ses and
patients. The intent was to identify
not onl y how much fr eedom nur ses
see for themsel ves but al so how
much fr eedom they can al l ow for the
patient. The tool was administer ed
to 702 nur ses in five differ ent setting
(200 RNs in a community teaching
hospital ; 206 nur sing administr ator s
in the Wester n U.S., & 296 nur ses
for m other hospital settings).
Pankr atz, L. & Pankr atz, D (1974).
Nur si ng autonomy and pati ents
r i ghts: Devel opment of a nur si ng
atti tude scal e. Jour nal of Heal th
Social Behavior , 15, 211- 216.
DESCRI TPTI ON: The tool consisted
of a 69 i tem atti tudi nal scal e. A
pr i nci pal components factor
anal ysis r esul ted in thr ee sub scal es
that adequatel y r epr esented the
i ntent of the study: (1) nur si ng
autonomy and advocacy; (2)
patients r ights; and (3) r ejection of
tr aditional r ul e l imitations. The sub
scal e scor es wer e associated with
educati on, l eader shi p, academi c
settings and non- tr aditional social
cl imate.
PURPOSE: The pur pose of the tool is
to examine thr ee separ ate attitudes
i n nur ses: nur si ng autonomy,
patients r ights and r ejection of the
tr aditional r ol e.
Pankr at z Nur si ng
Aut onomy & Pat i ent s
Ri ght Scal e
79
Bl aney, D. R., Hobson, C. J. &
Stepni ewski , A. B. (1990).
Measur ing nur sing attitudes towar d
cost- effecti veness: Fur ther devel -
opment & eval uati on of the
Bl aney/ Hobson Scal e. In Wal tz, C., &
Str ickl and, O. L. (Eds.) Measur ement
of Nur si ng Outcome Vol . 3. New
Yor k: Spr inger .
DESCRI TPTI ON: Twenty- two item
questi onnai r e posi ng cost- r el ated
statements that el i ci t atti tudes.
Responses ar e scor ed on a 5 point
Liker t Scal e r anging fr om str ongl y
disagr ee to str ongl y agr ee.
RELI ABI LI TY: The author s test that
the tool i s " hi ghl y r el i abl e" and
exceeds minimum standar ds.
VALI DI TY: Resul ts of tool testi ng
i ndi cate that the tool i s val i d,
accor ding to the author s.
BACKGROUND: The devel opment
of the tool is based on the Fishbein &
Aj zen model (1972, 1975) whi ch
indicates that attitudes ar e l ar gel y
based on bel iefs about the attitude
object. The model emphasizes that
ther e i s a cr i ti cal connecti on
between atti tudes and behavi or ,
and that attitudes can be devel oped
and changed by focusing on bel iefs
about the attitude object.
attitudes about cost- effectiveness of
nur sing pr actices and pr ocedur es.
Bl aney / Hobson Nur si ng
At t i t ude Scal e
80
RELI ABI LI TY: Inter r ater r el iabil ity
was .92. Cor r el ation r efl ecting the
consistency of subjects r esponses
acr oss items was .64.
VALI DI TY: Indicator s of val idity ar e
r epor ted.
BACKGROUND: A br iefer and mor e
r eadil y scor abl e test than Kohl ber gs
MJI. Can be used i n par al l el wi th
Kohl ber gs MJI.
Hogan, R. & Dickstein, E. (1972). A
measur e of mor al val ues. Jour nal of
Consul ti ng & Cl i ni cal Psychol ogy,
39, (2), 210- 214.
DESCRI TPTI ON: A 15- i tem
pr ojective measur e. Items ar e in the
for m of shor t statements concer ning
contempor ar y social & mor al issues
to which the subject r esponds as if he
wer e i n a conver sati on. The
r esponses ar e r ated by 5 scor es.
Each r esponse can r eceive a scor e of
0- 2.
val ues expr essed i n mor al
judgments.
Sur v ey of Et hi cal
At t i t udes
81
Doukas, D, & Gor enfl o, D. (1993).
Anal yzi ng the val ues hi stor y: An
eval uati on of pati ents medi cal
val ues and advance di r ecti ves.
Jour nal of Cl inical Ethics, 4(1), 41-
45.
D ESCR I T P T I O N : Tw o - p a r t
instr ument using Liker t scal es and
cer tain demogr aphic data: Par t I -
sur veys val ues and bel i efs i n
r el ation to ter minal car e incl uding
18 val ue stem questions r ated on a 7
poi nt scal e fr om favor abl e to
unfavor abl e; Par t II - assesses
famil iar ity with advance dir ectives
on a 5 point scal e; Par t III - r ates 2
qual i ty ver sus l ength of l i fe
questions on a 5 point scal e fr om
str ongl y agr ee to str ongl y disagr ee;
Par t IV a scenar io of ter minal il l ness
is r ated on a 5 point scal e.
RELI ABI LI TY: Pr incipal component
factor anal ysi s of the 18 val ue
statements di scussed thr ee
psychol ogical l y meaningful factor s
(communi cati on, fami l y bur den,
physician compl iance). Al phas wer e
.69, .66, .67, r espectivel y. Pr incipal
Components anal ysi s of the 11
ter minal car e dir ective statements
r eveal ed thr ee factor s (basi c-
ongoing car e, fundamental - acute,
code- suppor t). Al phas wer e .80,
.76, .87, r espectivel y.
VALI DI TY: Not Repor ted.
BACKGROUND: The Val ues Histor y
Instr ument was devel oped because
deci si on maki ng has r ai sed the
question of the impor tance of val ues
i n el i ci ti ng advanced di r ecti ves. It
suppl ements the l i vi ng wi l l and
dur abl e power of attor ney i n the
documentati on of Advance
Dir ectives.
PURPOSE: Identifies val ues r el ated
to advance dir ectives pr efer ences.
Val ues Hi st or y
82
RELI ABI LI TY: Repor ted in Manual
(1970).
VALI DI TY: Repor ted i n Manual
(1970).
BACKGROUND: Based on the wor k
for Spr anger (1928/ 1966) who
descr ibed six val ues or eval uative
attitudes. Accor ding to his theor y, a
per sons inter est and motives can be
under stood best by deter mining the
r el ati ve pr omi nence of these si x
basic val ues. The six basic attitudes
ar e: theor eti cal , economi cs,
aestheti c, soci al , pol i ti cal &
r el igious.
Al l por t, G. W., Ver non, P., & Lindsey,
G. (1970). Manual for The Study of
Val ues (3r d. ed.) Boston, Houghton
Miffl in.
DESCRI TPTI ON: Two par t tool : Par t
I - 30 questions or situations with 3
points between two al ter natives for
each questi on; Par t II - 4 choi ces
r anked to each of 15 questions in
or der of per sonal pr efer ence. The
numer ical val ues for each item ar e
total ed for a scor e on each of the six
scal es.
PURPOSE: Measur es the r el ati ve
impor tance of six basic inter ests or
motives in per sonal ity.
Al l por t - Ver non- Li ndzey
St udy of Val ues
83
Gool d, S., Hofer , T., Zimmer man, M.,
and Haywar d, R. (1994). Measur ing
physi ci an atti tudes towar d cost,
uncer tai nty, mal pr acti ce and
uti l i zati on r evi ew. Jour nal of
Gener al Inter nal Medicine, 9, 544-
548.
incl udes 56 attitude statements in:
costs of medical car e; uncer tainty in
deci si on maki ng; mal pr acti ce and
l i abi l i ty; medi cal technol ogy;
pr acti ce styl e; and, uti l i zati on
r eview. A five point Liker t scal e was
used r angi ng fr om (1) str ongl y
agr ee to (5) str ongl y di sagr ees.
Questi ons about demogr aphi c &
pr actice char acter istics, as wel l as
four items r equesting sel f appr aisal
of r esour ce use r el ative to peer s, ar e
al so incl uded.
RELI ABI LI TY: Scal e r el i abi l i ti es
r anged for m 0.66 to 0.86)
Cr onbachs al pha.
VALI DI TY: Expl or ator y factor s
anal ysis r eveal ed four factor s (fear
of mal pr actice, cost- consciousness,
annoyance with util ization r eview &
di scomfor t for uncer tai nty).
Congr uency coefficients for the four
factor s acr oss 2 data sets r anged
fr om 0.92 to 0.96.
BACKGROUND: Statements r el ated
to atti tudes that may i nfl uence
r esour ce use wer e cul l ed fr om
l iter atur e and infor mal discussions
with physicians.
PURPOSE: Measur es attitudes that
i nfl uence r esour ce uti l i zati on,
especi al l y cost consci ousness,
discomfor t with uncer tainty, fear of
mal pr acti ce, and annoyance wi th
util ization r eview.
At t i t udes Tow ar d
Resour ce Use
84
RELI ABI LI TY: Test/ r etest r el iabil ity
was .92 for total scor e; .84 for
Ethical - Emotional subscor e, and .88
for Rational - Behavior al Subscor e.
VALI DI TY: Factor anal ysis yiel ded
two factor s: Ethi cal - Emoti onal
(eigenval ue =^6.9) and Rational -
Behavi or al (ei genval ue = 1.86)
accounting for 31% of var iance.
BACKGROUND: The devel opment
of this instr ument was infl uenced by
the r ej ecti on of The Val ues
Cl ar ification movement dur ing the
1970s. Based on the wor k of Raths et
al . (1966, 1978) it attempts to meas-
ur e The state of being cl ar ified in
ter ms of ones val ues assuming that
cl ar ifying ones val ues is a wor thy
good.
Kinnier , R. (1995). A r econceptual -
ization of val ue cl ar ification: Val ues
confl i ct r esol uti on. Jour nal of
Counsel i ng and Devel opment, 74,
18- 24.
DESCRI TPTI ON: The VCRA consists
of thr ee par ts: confl ict descr iption;
for ced confl i ct r esol uti on; and,
r esol ution eval uation. Par t 1: identi-
fication of the specific val ue confl ict
Par t 2: i nstr ucti on to attempt to
r esol ve the par ticul ar confl ict Par t 3:
eval uati on of the r esol uti on by
r espondi ng to 17 standar di zed
Liker t scal ed items. The VCRA yiel ds
two subscor es and a total scor e of
confl ict r esol ution.
PURPOSE: Assesses the extent to
whi ch an i ndi vi dual has r esol ved
speci fi c val ues confl i cts, one at a
time.
Val ues Conf l i ct
Resol ut i on Assessment
( VCRA)
85
Nevil l , D. and Super , D. (1986). The
val ue scal e: Theor y, appl ication and
r esear ch manual . Consul ti ng
Psychol ogists Pr ess.
DESCRI TPTI ON: The Val ues Scal e
contai ns 106- i tems scor ed for 21
val ues. The val ues measur ed ar e
Abi l i ty Uti l i zati on, Achi evement,
Advancement, Aesthetics, Al tr uism,
Author i ty, Autonomy, Cr eati vi ty,
Economi c Rewar ds, Li fe Styl e,
Per sonal Devel opment, Physi cal
Acti vi ty, Pr esti ge, Ri sk, Soci al
Inter acti ons, Soci al Rel ati ons,
Var i ety, Wor ki ng Condi ti ons,
Cul tur al , Identity, Physical Pr owess,
and Economic Secur ity.
RELI ABI LI TY: Repor ted to be good
for sur vey pur poses.
VALI DI TY: Constr uct val i di ty i s
evidenced by the inter col l ations of
The Scal es and by thei r factor
str uctur e, constr uct and concur r ent
val idity ar e confir med by sex, age,
and cur r icul ar data.
PURPOSE: Pr ovides measur ement
of a number of intr insic and extr insic
val ues not assessed by exi sti ng
measur es. Can be used with upper
el ementar y on mi ddl e school
students as wel l as wi th adul ts
member s of var ious wor k r el ated or
pr ofessional gr oups.
Val ues Scal e
86
RELI ABI LI TY: Was assessed for
each constr uct as wel l as for each of
the 12 i tems. Intr acl ass " r "
coefficients for the constr ucts wer e
pr ofessi onal r esponsi bi l i ty = 0.75;
effi cacy of hospi ce = 0.85, and
cl inician / patient communication =
0.79. Al l 12 items together was 0.86.
assessed by factor anal ysis. Per cent
of total var i ance expl ai ned by 3
factor s was 47.6%. Factor 1=40.9%;
Factor 2=32.3%; Factor 3=26.8%.
BACKGROUND: Impr ovement of
end of l ife car e of patients is needed
but this wil l r equir e attitude changes
among cl inicians towar ds ter minal
i l l ness. Pr ogr ams to modi fy
cl i ni ci ans atti tudes ar e under way
but ther e ar e not adequate
measur es of their efficacy.
Br adl ey, E. H., Cicchetti, D. V., Fr ied,
T. R.; et al (2000). Attitudes about
car e at the end - of- l i fe among
cl i ni ci ans: A Qui ck, r el i abl e, and
val i d assessment i nstr ument.
Jour nal of Pal l iative Car e, 16(1): 6-
14.
consists of 12 items that measur e
thr ee attitudinal contr acts: (1) extent
of r esponsi bi l i ty for car e of dyi ng
patients, (2) The efficacy of hospice,
and (3) the impor tance of cl inicians-
patient communication about dying.
Uses a 5- point Licker t scal e.
PURPOSE: To measur e physicians
and nur ses attitudes towar ds car e
at the end - of - l ife.
At t i t udes Towar d Car e at
t he End - of - Li f e
( ATCEL)
87
patient distr ess. IMAGE, 27 (4), 317-
322.
scor ed on a 5- point scal e.
RELI ABI LI TY: Hi gh r el i abi l i ty
incl uding good inter nal consistency.
confir med by factor anal ysis of eight
mood factor s.
BACKGROUND: Adjectives ar e used
to descr i be feel i ngs and moods.
Individual scor es for tension, anger
and depr ession ar e used by Ol son in
the study.
PURPOSE: Measur e of patient dis-
tr ess.
MOODS( V/ A/ M) 4. 0
Pr of i l e of Mood St at es
I nv ent or y ( POMS)
88
RELI ABI LI TY: Wel l suppor ted by
Lake, Mil es, Ear l e, 1973; Lubin and
Zucker man, 1967; Zucker man and
Biase, 1962; Zucker man and Lubin,
1965; Zucker man, Lubin, Vogel and
Val er ius, 1964.
VALI DI TY: Wel l suppor ted by Lake,
Mi l es, Ear l e, 1973; Lubi n and
Zucker man, 1967; Zucker man and
Biase, 1962; Zucker man and Lubin,
1965; Zucker man, Lubin, Vogel and
Val er ius, 1964.
patient distr ess. IMAGE, 27 (4), 317-
322.
DESCRI TPTI ON: Sel f - admi ni s-
ter ed tool consi sti ng of 132
adjectives fr om measur ing states of
anxi ety, depr essi on and anger
Range of scor es: Anxi ety: 0- 21
Depr ession: 0- 40 Anger : 0- 28.
PURPOSE: Measur es states of
anxiety, depr ession and anger .
Mul t i pl e Af f ect Adj ect i v e
Check Li st ( MAACL)
MOODS ( V/ A/ M) 3. 0
89
MacEl veen, P. (1978). An obser va-
ti onal measur e of pati ent mor al e:
The Behavi or Mor al e Scal e.
Common Nur si ng Resear ch
Bicentennial Year , 9, 85- 92.
DESCRI TPTI ON: The BMS i s a
si mpl e test, qui ck and easy to
admi ni ster . The r ater obser ves
ver bal and nonver bal behavior of
the patient for a br ief per iod of time
and then r ates him on each of 17
items in a 5- point scal e r el ating to
postur e, body atti tude, motor
movements, faci al expr essi on,
speech and ver bal i zati ons, and
gener al attitude.
Behav i or Mor al e Scal e
RELI ABI LI TY: A r el iabil ity coeffi-
ci ent of 0.95 was obtai ned usi ng
Cr onbachs al pha. El i mi nati on of
tr oubl esome items 1 and 13 r aised
the al pha to 0.98.
VALI DI TY: Face val i di ty was
deter mined by a panel of exper ts.
Rank or der cor r el ation coefficients
fr om a Denver study i ndi cated
significant cor r el ation between the
BMS and the mor al e questi on by
pati ents (0.60), di al ysi s par tner
(0.70) and staff (0.48) indicating that
the BMS measur ed which patients
par tner s and staff al l vi ewed as
"mor al e."
BACKGROUND: The BMS was
devel oped fr om the behavior al cues
der i ved fr om l engthy di scussi on
with dial ysis center staff member s,
who r epor ted that they wer e making
i ntui ti ve j udgments of pati ent
mor al e.
PURPOSE: Measur es pati ent
mor al e.
90
RELI ABI LI TY: high cor r el ation: r =
0.95.
BACKGROUND: In an effor t to
facil itate the use of the POMS with
pati ents under str ess or pai n, a
shor ter ver si on of the POMS was
devel oped. Each of the or i gi nal
POMS scal es was r educed by 2 to 7
i tems wi thout l osi ng i nter nal
consistency.
Shacham, S. (1983). A shor tened
ver sion of the pr ofil e of mood states.
Jour nal of Per sonal ity Assessment,
47 (3), 305- 306.
DESCRI TPTI ON: The shor tened
ver sion consists of 37 items r ated on
a 5- point scal e fr om 1 = not at al l to 5
= extr emel y.
PURPOSE: Measur es tr ansi ent,
distinct mood states.
Pr of i l e of Mood St at es
I nv ent or y - Shor t
Ver si on ( PMOS)
MOODS ( V/ A/ M) 3. 0
91
Debats, D.L. (1998). Measur ements
of per sonal meani ng: The
psychometr ic pr oper ties of the l ife
r egar d index. In P.T.P. Wong & P. S.
Fr y (Eds.), The Human Quest for
Meani ng: A Handbook of
Psychol ogical Resear ch and Cl inical
Appl i cati on, (pp. 237- 259).
Lawr ence Er l baum Associ ates,
Pal es., Mahwah, N.J.
DESCRI TPTI ON: This 28 item ques-
ti onnai r e contai ns two subscal es:
Fr amewor k and Ful fi l l ment (14
items each), These items ar e r ated
on 3 point Liker t scal es with hal f of
the questi ons i n each subscal e
wor ded positivel y and hal f wor ded
negativel y.
Li f e Regar d I ndex ( LRI )
RELI ABI LI TY: hi gh Test- r etest
r el iabil ity r epor ted (r =.80 for Index,
r =.73 for sub scal e Fr amewor k,
r =.79 for Ful fil l ment sub scal e.
VALI DI TY: Concur r ent val i di ty
suppor ted i n sever al studi es-
content val idity establ ished by LRI
scor es si gni fi cantl y r el ated to the
degr ee of subjects commitment to
their per sonal meanings in l ife, Thus
suppor ting Theor y fr om which LRI
der i ved, Str ong evi dence for
discr imenant constr uct val idity and
pr edictive val idity is r epor ted.
BACKGROUND: The tool was
desi gned by Batti sta & Al mond
(1973) to over come the weaknesses
of The Pur pose i n Li fe test (PIL)
(Cr umbaugh & Mohol ick, 1964). The
weaknesses of The PIL incl ude: (a)
bl endi ng of concepts such as
per sonal meani ng, fear of death,
and fr eedom, (b) a l ack of consisten-
cy i n The meani ngs of PIL i tems
acr oss subcul tual gr oups; and (c)
PURPOSE: Measur es per sonal
meaning or positive l ife r egur d.
substanti al l oadi ng on soci al
desir abil ity with Cr owne- Mar l owe
Social Desir abil ity Scal e.
92
RELI ABI LI TY: Test- r etest r el iabil ity
of the ABLS- 2 is r =. 85 (p < 0.001)
wi th 121 students and one week
between testing. Inter nal consisten-
cy, coefficient al pha, was 0.68.
VALI DI TY: Suppor ted by the near l y
par al l el cor r el ations between both
the ABLS and UCLA measur es of
l onel iness and a var iety of cr iter ion
var i abl es. (Sel f- esteem, soci al
ski l l s, devel opmental backgr ound
var i abl es, emoti onal exper i ences
when l onel y.
di scover the emoti onal and
behavior al cor r el ates of l onel iness
as i t r el ates to qual i ty of l i fe and
spir itual wel l being. Author s initial l y
used the UCLA Lonel iness Scal e, but
thr ee pr obl ems became appar ent:
al l items wer e wor ded negativel y
and in the same dir ection (r esponse
set bias coul d infl uence the scal e);
r esponding to a l ong l ist of negative
Pal outzin, R. and El l ison, C. (1982)
Lonel iness, spir itual wel l being and
qual ity of l ife. In L. Peopl e and D.
Per l man (Eds). Lonel i ness: A
Sour cebook of Cur r ent Theor y,
Resear ch, and Ther apy, 224- 237.
Wil ey Inter science: NY.
DESCRI TPTI ON: The tool consi sts
of seven items scor ed on a 4 point
scal e: O = often, S = sometimes, R =
r ar el y, N = never . Four of the seven
i tems ar e stated i n the posi ti ve
dir ection.
PURPOSE: Measur es l onel iness.
Abbr ev i at ed Lonel i ness
Scal e, Ver si on 2 ( ABLS -
2 )
MOODS ( V/ A/ M) 3. 0
i tems coul d be a negati ve
exper ience; and, scal e l ength.
93
PROFESSI ONAL ROLE ( V/ A/ P) 4. 0
Wei s, D. & Schank, M. (2000). An
instr ument to measur e pr ofessional
nur sing val ues. Jour nal of Nur sing
Schol ar ship, 32(2), 201- 204.
DESCRI TPTI ON: A 44- item sur vey
usi ng Li ker t scal e. Each i tem can
r ecei ve a scor e of one to fi ve.
Possi bl e scor es r ange fr om 44 to
220, with the higher scor e indicating
a better under standi ng of nur si ng
val ues. The items ar e statements
taken fr om the ANA code and
pr esented wi th i nter pr etve
commentar y.
Nur si ng Pr of essi onal
Val ue Scal e
RELI ABI LI TY: Repor ted to be good.
VALI DI TY: The val i di ty was
establ ished by a panel of five judges
who ar e exper ts on the code for
nur ses.
devel eoped becuase val ues ar e in
integr al par t of nur sing, yet no tool
existed to accur atel y measur e them.
It is based on a r eview of l iter atur e
about the nur si ng code of ethi cs,
val ues and pr ofessi onal val uei n
devel opment in nur ses.
PURPOSE: Measur es pr ofessi onal
nur si ng val ues based on the
Amer ican Nur ses Association (ANA)
code.
94
Rol e Responsi bi l i t i es
Quest i onnai r e
BACKGROUND: This tool was cr e-
ated to compar e the ethical views of
nur ses ar ound the wor l d and to dis-
cover how the Chinese, Amer ican,
and Japanese nur ses vi ew thi ew
ethical r esponsibil ities.
Pang, S., Sawada, A., Konishi, D. Yu,
P., Chan, M., & Mayumi, N. (2003). A
compar ati ve study of Chi nese,
Amer i can and Japanese nur ses
per ceptions of ethical r ol e r esponsi-
bi l i ti es. Nur si ng Ethi cs 2003,
10(3),295- 311.
DESCRI TPTI ON: A l ist of 56 state-
ments that wer e taken fr om state-
ments made by Chinese, Amer ican,
and Japanese nur ses dur ing inter -
views. The statements fal l into four
r ol e- r el ati onshi p categor i es:
r esponsibil ities in r el ation to society,
patients and their famil ies, pr ofes-
sional r ol es, and hospital pr actices.
Al l 56 statements ar e r anked on a
scal e of zer o to ten with zer o being of
no impor tance. The data is anal zed
using mul tidimensional pr efer ence
anal ysis.
PURPOSE: To outl ine sociocul tur al
factor s that infl uence nur ses views
of ethical r esponsibil ities.
PROFESSI ONAL ROLE ( V/ A/ P) 4. 0
95
PROFFESSI ONAL ROLES 4. 0
Whi st l e Bl ow i ng
RELI ABI LI TY: Rel iabil ity was l ow
but that was expected by the design-
er s of the sur vey because of the
natur e of the tool .
VALI DI TY: Establ ished via Lynns
content val idity index.
BACKGROUND: The ethi cal
r esponsi bi l i ti es of a nur se di ctate
that he or she r epor t misconduct on
the par t of another heal thcar e
wor ker , which jeopar dizes patient
safety. Such events often go unr e-
por ted because of the per sonal and
pr ofessional r isks imposed on the
whi stl ebl ower . Thi s sur vey was
designed to compar e the differ ences
between the bel iefs of those nur ses
who do act as whistl ebl ower s and
those who chose to ignor e such inci-
dents.
Aher n, K. & McDonal d, S. (2002).
The bel i efs of nur ses who wer e
invol ved in a whistl ebl owing event.
Jour nal of Advanced Nur sing, 38(3),
303- 309.
DESCRI TPTI ON: Thi s sur vey
i ncl udes ten statements der i ved
fr om cur r ent codes of nur sing ethics,
tr adi ti onal vi ews of the r ol e of a
nur se and basic bel iefs. The state-
ments ar e r ated on a 5- point Liker t
scal e.
PURPOSE: To expl or e the acti ons
and bel iefs of nur ses who wr estl ed
with the ethical dil emma of whether
or not to be a whistl ebl ower .
96
Ol ive, K. (1995). Physician r el igious
bel i efs and the physi ci an- pati ent
r el ati onshi p: A study of devout
physi ci ans. Souther n Medi cal
Jour nal , 88 (12), 1249- 1255.
DESCRI TPTI ON: Tool contai ns: 4
items of demogr aphics; 18 items of
r el igious bel iefs sur vey; 19 items of
atti tudes and pr acti ces r egar di ng
inter action between r el igious bel iefs
and medical pr actice; 17 items on
atti tudes r egar di ng speci fi c
biomedical issues; and a comment
section. The r esponses wer e r ated
on a 5 point scal e r anging fr om (1)
str ongl y di sagr ee to (5) str ongl y
agr ee.
RELI ABI LI TY: Assessed by r eview
of content exper ts.
devel oped so that cl inical situations
wher e medi cal management of
pati ents mi ght be affected by
physicians r el igious bel iefs.
PURPOSE: Measur es the type and
fr equency of r el igious inter actions
that occur between devout
physicians and their patients.
SPI RI TUAL ( V/ A/ SP) 5. 0
Rel i gi ous Bel i ef s
I nst r ument
97
RELI ABI LI TY: Test/ r etest r el iabil ity
coeffi ci ent was 0.93. Coeffi ci ent
al pha was 0.89.
VALI DI TY: Face val i di ty i s
suggested by as examination of item
content.
devel oped to pr ovi de addi ti onal
measur ement of qual ity of l ife by
pr oviding a r el iabl e & val id measur e
of r el i gi ous di mensi ons that
contr ibute to qual ity of l ife.
El l si on, C. (1983). Spi r i tual Wel l
bei ng: conceptual i zati on and
measur ement. Jour nal of
Psychol ogy and Technol ogy, 11 (4),
330- 340.
DESCRI TPTI ON: The SWBS consists
of 20 i tems, 10 concentr ated on
r el i gi ous wel l bei ng and 10 on
existential wel l being. The items ar e
scor ed on a 7 point Liker t scal e.
PURPOSE: Measur es both r el igious
and existential wel l - being.
I nf l uence of Spi r i t ual
Wel l Bei ng Scal e ( SWBS)
98
Mober g, D. (1984). Subj ecti ve
measur es of spi r i tual wel l - bei ng.
Revi ew of Rel i gi ous Resear ch, 25
(4), 351- 364.
D E S C R I T P T I O N : 8 2 - i t e m
questionnair e . Scor ing var ied fr om
tr ue/ fal se to a 4- point scal e in the
var i ous i ndexes. Seven Indexes
wer e identified: Chr istian Faith: sel f-
sati sfacti on, per sonal pi ety,
subj ecti ve sel l bei ng, opti mi sm,
r el igious cynicism, and el itism.
pr ovided.
pr ovided.
devel oped by combi ni ng
i nstr uments that measur e var i ous
aspects of SWB & adding new items
incl uding sever al gal l up Pol l items
(used with per mission).
PURPOSE: Measur es spi r i tual
wel l - being
Spi r i t ual Wel l Bei ng
Quest i onnai r e
99
RELI ABI LI TY: Establ i shed by
test- r etest method. Pear son
cor r el ati on of r =0.88 suppor ts
stabi l i ty of i nstr ument. Inter nal
consistency using Cr onbachs Al pha
in four r esear ch studies r anged fr om
0.79 to 0.91.
VALI DI TY: Cr i ter i on- r el ated
val idity was assessed by cor r el ating
scor es of this scal e with those of The
Pal outzian & El l ison Spir itual Wel l -
Being Scal e. A cor r el ation of 0.82
(p=. 000) between the two scal e is
r epor ted.
Fol ey, L., Wagner , J., & Waskel , S.A.
(1998). Spi r i tual i ty i n the l i ves of
ol der women. Jour nal of Women &
Aging, 10(2), 85- 91.
DESCRI TPTI ON: Scal e of 21 items
using a 6 point Liker t- type for mat to
r ate r esponse fr om str ongl y agr ee to
str ongl y disagr ee.
PURPOSE: To measur e spi r i tual
wel l - being.
SPI RI TUAL( V/ A/ SP) 5. 0
JAREL Spi r i t ual Wel l -
Bei ng Scal e
100
RELI ABI LI TY: Not known.
VALI DI TY: Not known.
DESCRI TPTI ON: The eval uati on
questi onnai r e consi sts of thr ee
sections. In section 1, pr ofessional
staff is asked the major r easons for
cal l ing consul tation. In section two,
al l r espondents ar e asked to answer
7 questions on a 3- point scal e: ver y
hel pful , somewhat hel pful and not
hel pful . Secti on thr ee contai ns 3
wr i tten questi ons aski ng the
r espondents opinions and for other
comments.
PURPOSE: Measur es medi cal
ethics consul tation effectiveness.
BACKGROUND: To study the
per ceived effectiveness of bioethics
consul tation as eval uated by both
pr ofessional staff and their famil ies.
An eval uati on questi onnai r e was
for war ded to physicians, nur ses and
pati ents or fami l y member s who
wer e associated with 20 sequential
cases r efer r ed for ethi cs
consul tation dur ing a 2- year per iod.
Respondents wer e asked to r ate the
consul t as ver y hel pful , somewhat
hel pful or not hel pful concer ning a
var iety of issues r el ated to the car e
of pts.
McCl ung, J., Kr amer , R., DeLuca, M.
and Bar ber , H. (1996). Eval uation of
a medi cal ethi cs consul tati on
ser vi ce: opi ni ons of pati ent and
heal th car e pr ovider s. The Amer ican
Jour nal of Medicine, 100, 456- 460.
ETHI CS CONSULTATI ON ( E/ EC) 1. 0
Bi oet hi cs Consul t at i on
Quest i onnai r e
Et h i c s
101
RELI ABI LI TY: Cr oss- val i dati on
per for mance was identical to or onl y
0.01 points l ower than the per for m-
ance of model s devel oped using the
entir e data set.
VALI DI TY: Each of the six cl inical
findings has a str ong r el ationship (P<
0.001) with in- hospital death which
suppor ts the val idity of the findings.
DESCRI TPTI ON: Measur es over al l
sever ity based on: Admission medic
gr oup scor es, physi ol ogy scor e,
di sease stagi ngs scal e, and al l
pati ent r efi ned di agnosi s r el ated
gr oups (APR- DRG). Patients r anked
by pr edicted pr obabil ity of death.
PURPOSE: Measur es i l l ness
sever ity and pr obabil ity of death.
BACKGROUND: To deter mi ne
whether assessments of i l l ness
sever i ty, defi ned as r i sk for i n-
hospital death, var ied acr oss four
measur es. For each pati ent, the
pr obabil ity of death was r ated on
each of the measur e scal es. Patients
wer e r anked accor di ng to the
pr obabil ity of death as pr edicted by
each sever i ty measur es and
r anki ngs wer e compar ed acr oss
measur es.
Iezzoni , L., Ash, A., Shwar tz, M.,
Dal ey, J., Hughes, J. and Makier nan,
Y. (1995). Pr edi cti ng who di es
depend on how sever i ty i s
measur ed: i mpl i cati ons for
eval uating patient outcomes. Annal s
of Inter nal Medicine, 123, (10), 763-
770.
PATI ENT OUTCOMES ( E/ PO) 2. 0
I l l ness Sev er i t y
Measur es
Et h i c s
102
Et h i c s
RELI ABI LI TY: Cr onbachs al pha =
0.959.
VALI DI TY: Not r epor ted by
r esear cher s - constr uct val i di ty
r epor ted i n or i gi nal SERVQUAL
instr ument.
DESCRI TPTI ON: 49 statements
r ated on a 7 poi nt Li ker t scal e
r anging fr om 7 = str ongl y agr ee to 1
= str ongl y disagr ee.
PURPOSE: Measur es pati ents
r epor ted degr ee of sati sfacti on
based on consumer satisfaction with
ser vices.
Tomes, A. and Ng, S. (1995). Ser vice
qual i ty i n hospi tal car e: The
devel opment of an i npati ent
questionnair e. Inter national Jour nal
of Heal th Car e Qual ity Assur ance, 8
(3), 25- 33.
SERVQUAL
103
RELI ABI LI TY: The total scal e
r el iabil ity was r epor ted as cl ose to
.9 in each of the four instances.
VALI DI TY: Constr uct val i di ty
r epor ts based on conceptual
cr iter ion and empir ical measur es.
DESCRI TPTI ON: 22- i tem scal e
scor ed on a 7- point scal e r anging
fr om 7 = str ongl y agr ee to 1 =
str ongl y disagr ee.
PURPOSE: To assess consumer
per cepti ons of ser vi ce qual i ty i n
ser vice and r etail ing or ganizations.
Par asur man, A., Zei thaml , V. and
Ber r y, L. (1988). SERVQUAL: A
mul tipl e- item scal e for measur ing
consumer per cepti ons of ser vi ce
qual ity. Jour nal of Retail ing, 64 (1),
12- 40.
SERVQUAL- Shor t f or m
Et h i c s
104
Wo r l d Vi e w s
RELI ABI LI TY:
Cr onbachs al pha was .80 for ide-
al ism and .73 for r el ativism
Test- r etest was .67 for ideal ism
and .66 for r el ativism.
VALI DI TY:
Var imax r otation for 16 items =
77%
Constr uct and discr iminate val idi-
ty wer e establ ished.
For syth, D. (1980). A taxonomy of
ethi cal i deol ogi es. Jour nal of
Per sonal ity and Social Psychol ogy,
39(1), 175- 184.
contains 20 attitude statements, 10
concer ni ng i deal i sm and 10
concer ning r el ativism. Respondents
ar e asked to indicate their degr ee of
agr eement or di sagr eement wi th
each item using a 9 point scal e. The
scal e r anges fr om 1 = compl etel y
disagr ee to 9 = compl etel y agr ee.
PURPOSE: Measur es the extent to
which individual s adopt one of four
ethi cal i deol ogi es: si tuati ons,
absol uti sm, subj ecti vi sm, and
excepti oni sm i n maki ng mor al
judgements.
BACKGROUND: The EPQ assesses
the degr ee of ideal ism and r ejection
of univer sal mor al r ul es in favor of
r el ativism to eval uate to what extent
i ndi vi dual s adopt the ethi cal
ideol ogies under differ ent types of
mor al judgements.
ETHI CAL I DEOLOGI ES ( WV/ EI ) 1. 0
Et hi cs Posi t i on
Quest i onnai r e
105
Wo r l d Vi e w s
Not avail abl e.
consists of 59 items scor ed on a five
point scal e r anging fr om 1 = never
impor tant to 5 = al ways impor tant.
PURPOSE: Asseses the wor l d views
of facul ty i nvesti gator s for
r ecogni ti on of ethi cal i ssues and
wei ghi ng of ethi cal pr i nci pl es i n
human subject r esear ch.
BACKGROUND: Letter of intr oduc-
ti on and questi onnai r e sent to
facul ty member s i n denti str y,
nur sing or phar macy hol ding both a
pr ofessional and doctor al degr ee.
RESEARCH ( WV/ RS) 2. 0
Wor l dVi ews of Facul t y
Resear ch I nv est i gat or s

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