Development of the Nurse Occupational Stigma Scale

Introduction: Occupational stigma toward nurses exerts a negative impact on the physical and mental health and work performance of nurses. However, hitherto, there has been no quantitative instrument designed to assess occupational stigma toward nurses. Objective: The present study aimed to develop the Nurse Occupational Stigma Scale (NOSS) and test its reliability and validity in the Chinese context. Methods: The items of the scale were formed through the open-ended interview and literature review. A questionnaire survey was administered among 765 patients using NOSS and the Caring Behaviors Inventory (CBI-24). Results: In the initial questionnaire, a total of 21 items were developed, and 5 items were dropped for cross-loadings. The formal scale consists of 16 items divided into three dimensions of negative label, nurse-patient relationship, and devaluation and discrimination. The results of confirmatory factor analysis (CFA) indicated that the three-factor model fitted well (chi(2)/df=2.635, RMSEA=0.064, RFI=0.926, CFI=0.962, NFI=0.941, IFI=0.953). The total scores of the NOSS and the scores of all dimensions were significantly negatively correlated with the scores of the CBI-24. The internal consistency coefficients of the scale and all dimensions were between 0.827-0.920, and the split-half reliability coefficients were between 0.826-0.942. The NOSS had the measurement invariance across gender. Conclusion: With its good reliability and validity, the NOSS can be an appropriate instrument for researchers to conduct studies about nurse occupational stigma.