Development and validation of traditional & complementary medicine (TCM) scales for nurses: Using structural equation modelling (SEM)

• Published in: BMC complementary and alternative medicine 2019-11, Vol.19 (1), p.321-321, Article 321
• Main Authors: Chang, Hsiao-Yun, Lo, Chia-Lun, Hung, Yun-Ying
• Format: Article
• Language: English
• Subjects: Adult; Alternative medicine; Analysis; Attitude of Health Personnel; Attitudes; Behavior; Chi-square test; Communication; Complementary Therapies; Evidence-based nursing; Female; Focus groups; Health care; Humans; Integrative medicine; Knowledge; Latent Class Analysis; Literature reviews; Male; Medical research; Multivariate statistical analysis; Nurses; Nurses - psychology; Nurses - statistics & numerical data; Nursing education; Patients; Preventive medicine; Psychometrics - methods; Psychometrics - standards; Quantitative psychology; Questionnaires; Registered nurses; Reliability analysis; Reproducibility of Results; Researchers; Statistical analysis; Structural equation modeling; Surveys and Questionnaires; Taiwan; Traditional Chinese medicine; Validity
• ISSN: 1472-6882; 1472-6882
• DOI: 10.1186/s12906-019-2733-z

This study aimed to develop and validate scales to assess attitudes towards patient' s use of TCM (APUTCM) and to measure a communicative competence in TCM (CCTCM) among nurses. The instrument development process was conducted from Sep 2013 to Jul 2014, using the following steps: 1) item development; 2) internal review and refinement; 3) face and content validation; 4) instrument administration to a development sample; and 5) evaluation of validity and reliability. A convenience sample was used to recruit registered and advanced practice nurses who worked in different regions throughout Taiwan. A total of 755 respondents completed the online questionnaire. Statistical analyses were performed using the software of SPSS Version 21.0 and Analysis of Moment Structures (AMOS) version 24.0. The scale-level indexes (S-CVI) of content validity for both scales were over 80%. The reliabilities for the 13-item APUTCM scale and for the five-item CCTCM scale were 0.88 and 0.84, respectively. The model suitability for both scales was assessed, and the findings revealed suitable parameters for all indicators: GFI = 0.954, AGFI = 0.932, CFI = 0.959, RMSEA = 0.62, and chi-square/df = 3.891 for APUTCM; and GFI = 0.992, AGFI = 0.969, CFI = 0.992, RMSEA = 0.63, and chi-square/df = 4.04 for CCTCM. The convergent and divergent validity of scores on both scales provided evidence in the expected direction. This scale development study provides preliminary evidence that suggests that the 13-item APUTCM and the five-item CCTCM are reliable and valid scales for assessing attitudes toward patient's TCM use and communicative competence in TCM.