Development and Psychometric Testing of NRICS

Ahtisham Younas

Development and Psychometric Testing of Nurses Relational Inquiry Capacities Scale (NRICS)

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The relational inquiry approach enables the nurses to recognize and examine multifaceted clinical situations and the interactions between patients and healthcare providers underlying these situations (Hartrick-Doane & Varcoe, 2015). In order to practicing from the relational inquiry perspective, the nurses need to expand their thinking horizons. It requires them to gain an in-depth understanding of people, situations, and relationships through recognition of various interpersonal, intrapersonal, and contextual factors shaping the nurse-patient interactions (Hartrick-Doane, 2014; Hartrick-Doane & Varcoe, 2015).

The relational inquiry approach also emphasizes the nurses’ need to identify their nursing obligations and to fulfil those obligations in the context of any given situation. Some of the nursing obligations are; to be reflective and intentional, to open one’s relational space for difficulties, and to act at interpersonal, intrapersonal, and contextual levels to influence the health and well-being of oneself and others (Hartrick-Doane & Varcoe, 2007). The core of the relational inquiry approach are the five ontological capacities; compassion, curiosity, commitment, competence, and correspondence which are required for effective nursing care (Hartrick-Doane & Varcoe, 2015). Therefore, the nurses who operate out of the relational inquiry perspective, or those who intend to adopt this approach, should possess these essential capacities.

There is a wide range of literature about some of these capacities which includes compassion, commitment, and competence (Lee & Seomun, 2016a, 2016b; Papadopoulos & Ali, 2016; Yang & Jiang, 2014; Burnell, & Agan, 2013). Much of this literature studies these capacities as single entities, rather than as a whole. However, according to Hartrick-Doane & Varcoe (2015) these five capacities complement each other and share an interdependent relationship. Therefore nurses who subscribes to the relational inquiry perspective, should use these capacities as a whole. However, no research could be found to substantiate whether nurses possess these capacities and whether they use these capacities as an interrelated whole. This dearth of literature could be because of the unavailability of a scale to measure these five capacities individually as well as a whole. Although several researchers have developed questionnaires to measure these individual capacities (Burnell, & Agan, 2013; Lee & Seomun, 2016b; Papadopoulos, Shea, Taylor, Pezzella, & Foley, 2016; Yang & Jiang, 2014), no tools could be found to measure these capacities as a whole. This is consistent with the findings of an integrative review. In this review, Papadopoulos and Ali (2016) outlined how competence and compassion are interrelated, but there is a need to develop instruments to measure compassion and other interrelated concepts. Although this integrative review only highlighted an area of research concerning compassion and competence, it implied that the other interrelated concepts should also be measured. Therefore, the purpose of this research practicum is develop a scale to measure these five capacities as single entities and as an interrelated whole.

This practicum will have several implications for the nursing profession. In the international context, the development of this scale will help nursing researchers and educators assess to what extent these important nursing capacities exits in their students. The clinical educators will be able to help their students to improve these nursing capacities and ultimately improve the standard of patient care. In the Canadian context, this practicum will help in the expansion of knowledge related to the relational inquiry approach. The nursing institutions and the nursing educators will be better able to assess their students. Based on this assessment they will be able to revise their educational policies and clinical guidelines.

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Purpose

The purpose of this research practicum is to develop Nurses Relational Inquiry Capacities Scale (NRICS) and determine its psychometric properties.

Practicum Objectives

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1. To understand the difference between a questionnaire, an inventory, and a scale.
2. To describe the steps involved in scale development in nursing research.
3. To understand the role of the Delphi technique/expert consultation in scale development.
4. To utilize existing scales and nursing theory as a guide for scale development.
5. To develop a scale for nursing researchers and educators to determine relational inquiry capacities of nursing students.

Setting of the Practicum

This research practicum will be conducted in the School of Nursing, Memorial University of Newfoundland (MUNSON). The target population will be the undergraduate nursing students enrolled in the school of nursing. The project will be conducted under the supervision of Dr. Caroline Porr, Associate Professor in the School of Nursing.

Methods

Three methods will be used for the development of this scale. First, a literature review will be conducted to identify the existing questionnaires/scales measuring these five constructs. The literature search will be performed from the databases: CINHAL, PubMed, Science Direct, and Google Scholar. Based on this literature review, the conceptual and operational definitions of these constructs will be compared with the conceptual definitions proposed in the relational inquiry approach. The items of the identified questionnaires/scales will be critically analyzed and if consistent, the items will be included in the NRICS. Second, using the Delphi technique the NRICS will be send for review to the authors of the relational inquiry approach and other nursing educators having expertise in this approach. Based on this experts’ review the NRICS will be revised. Third, a pilot study will be conducted to ensure the validity (face and content) and reliability (test-retest and inter-item correlation) of NRICS. Prior to the pilot study, the research approval will be obtained from the Health Research Ethics Authority (HREA)/ Interdisciplinary Committee on Ethics in Human Research (ICEHR). The data will be collected from the undergraduate nursing students at the MUNSON. The data collection will occur on two different occasions to determine the test-retest reliability of the scale.

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Advanced Nursing Practice Competencies

The Canadian Nurses Association (CNA) (2008) outlined several essential competencies of nurses under each of the four domains namely, clinical, research, leadership, and collaboration and consultations. Upon completion of this research practicum, I will have developed several research and consultation competencies. Among the research competencies, the CNA indicates that an advanced practice nurse should be able to “work as primary investigator or collaborator to conduct research for the benefit of nursing practice” (p. 23). Consistent with this competency, I will be able to work as a primary investigator to conduct a pilot testing of the NRICS. I will be able to conduct research to advance the nursing knowledge in scale development and relational inquiry based nursing practice. Another competency of an advanced practice nurse is to “critique, interpret, apply, and disseminate evidence-based findings” (p. 24). Consistent with this, I will be able to critique and analyze the available scales on the five constructs; compassion, competence, curiosity, commitment, and correspondence. I will be able to analyze and interpret the items in the existing scales in light of the relational inquiry approach. Based on this item analysis, I will develop the NRICS. Among the consultation competencies, the CNA indicates that an advanced practice nurses should “collaborate with other nurses and healthcare team members in a timely manner for quality improvement”. Consistent with this, I will be able to use the Delphi technique to consult various nursing experts for the development of NRICS. I will also collaborate with nursing management, nursing educators, and nursing students in the Memorial School of Nursing.

Time Line

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Week 11	Finalization of NRICS Proposal Submission to Health Research Ethics Authority (HREA)/ Interdisciplinary Committee on Ethics in Human Research (ICEHR)
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References    

Burnell, L., & Agan, D. L. (2013). Compassionate care: Can it be defined and measured? The development of the Compassionate Care Assessment Tool. International Journal of Caring Sciences, 6(2), 180-7.

Hartrick-Doane, G. (2014). Beyond relational oblivion. Advances in Nursing Science, 37(2), 84-86.

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Hartrick-Doane, G., & Varcoe, C. (2007). Relational practice and nursing obligations. Advances in Nursing Science, 30(3), 192-205.

Hartrick-Doane, G., & Varcoe, C. (2015). How to nurse: Relational inquiry with individuals and families in changing health and health care contexts. Philadelphia, PA: Lippincott Williams & Wilkins.

Canadian Nursing Association (CNA) (2008). Advanced nursing practice: A national framework Retrieved from: https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/anp_national_framework_e.pdf

Lee, Y., & Seomun, G. (2016a). Compassion competence in nurses. Advances in Nursing Science, 39(2), E54-E66.

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Lee, Y., & Seomun, G. (2016b). Development and validation of an instrument to measure nurses’ compassion competence. Applied Nursing Research, 30, 76-82.

Papadopoulos, I., & Ali, S. (2016). Measuring compassion in nurses and other healthcare professionals: An integrative review. Nurse Education in Practice, 16(1), 133-139.

Papadopoulos, I., Shea, S., Taylor, G., Pezzella, A., & Foley, L. (2016). Developing tools to promote culturally competent compassion, courage, and intercultural communication in healthcare. Journal of Compassionate Health Care, 3(1), 1-10. doi: 10.1186/s40639-016-0019-6

Yang, G. F., & Jiang, X. Y. (2014). Self-directed learning readiness and nursing competency among undergraduate nursing students in Fujian province of China. International Journal of Nursing Sciences, 1(3), 255-259.

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