Development and validation of a Dignity in Care Scale for Nurses

Background: Maintaining patient dignity is an important aspect of nursing care. No instrument is currently available to measure nurses' behaviours for maintaining patient dignity in clinical care. Objectives: To develop and test an instrument to measure activities nurses perform to maintain patient dignity in clinical care settings, guided by the literature and face-to-face interviews. Research design: A quantitative cross-sectional descriptive survey collected data from the developed scale, which was analysed by descriptive statistics and factor analysis. Participants and research context: Convenience samples of nurses participated in the interviews (n = 40) and examined face validity of the scale (n = 20). A purposive sample of 610 nurses was recruited from four regional hospitals in the northern, southern and eastern areas of Taiwan to test the developed scale. Ethical considerations: Research was approved by the Institutional Review Board of the study hospital. Information about the study was provided to nurses and those willing to participate provided written informed consent prior to data collection. Findings: The 36-item Dignity in Care Scale for Nurses had acceptable content and face validity. Factor analysis identified six factors necessary for maintaining dignity of patient care: communication skills, confidentiality of patient information, prompt response to patient needs, respect for patient's autonomy, providing a safe environment and protecting the patient's well-being. The reliability coefficient for the total scale was 0.93; alpha coefficients for the subscales ranged from 0.70 to 0.94. Discussion: The Dignity in Care Scale for Nurses was demonstrated to be a reliable and valid tool for assessing how nurses maintain dignity in care for patients in the clinical setting. The questionnaire can be used to provide feedback to nurses regarding patient dignity. Conclusion: Data gained from this instrument could be used to design nursing education programmes to help nurses enhance their abilities for maintaining patient dignity in clinical practice.