Development and Psychometric Evaluation of the Esthetics of Nursing Care Scale

Document Type: Original Article


Background: Esthetic knowledge is invaluable to enhance nursing practice to high standards. Therefore, it should be clearly operationalized in a way that facilitates its evaluation.
Objectives: The purpose of this study was to develop and evaluate the psychometric properties of the Esthetics of Nursing Care Scale (ENCS).
Methods: This descriptive methodological study was part of a sequential exploratory mixed methods research carried out in 2014. The primary item pool was developed based on the results of a literature review and an interpretive phenomenological study on 12 nursing clients and 14 nurses purposefully recruited from six general and specialty hospitals in Iran. During psychometric evaluation, the face, content, and construct validity as well as internal consistency and stability of the scale were assessed.
Results: The primary item pool contained 75 items while the final scale consisted of 38 items. Scale-level content validity index was measured twice; the results of both measurements were above 0.90. Exploratory factor analysis showed that the 38-item scale consisted of four factors which explained 60.75% of the total variance. Pearson correlation analysis between the score of the scale and the score of the “Caring Behavior Inventory” yielded a coefficient of 0.84 (P < 0.001). The Cronbach's alpha of the scale was 0.96. Moreover, intraclass correlation coefficient for test–retest stability with a 2-week interval was 0.93.
Conclusion: The 38-item ENCS has high and acceptable validity and reliability. Therefore, it can be employed as an appropriate instrument for the evaluation of the esthetics and the quality of nursing care from patients' perspectives.