The Development and Pilot Testing of an Instrument to Measure Nurses’ Working Environment: The Nursing Context Index

Development and psychometric evaluation of a Risky Sexual Behaviour Scale for Married Women (RSBS-MW) in Iran: a mixed-method study

A valid and reliable culture-based scale for the evaluation of risky sexual behaviours for married Iranian women is lacking. This study aimed to develop, and psychometrically test, a risky sexual behaviour scale for married Iranian women. A mixed-method sequential exploratory design was conducted from 2016 to 2020 in Tehran, Iran. First, a qualitative study was employed to define the concept of risky sexual behaviour using 16 semi-structured individual interviews and 10 focus group discussions (n = 100). Then, an item pool was generated, and the scale was developed. Finally, in the quantitative study, the psychometric properties of the scale were evaluated by validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 400 sexually active married women to assess the construct validity. The six components: (i) 'quality of sexual relations'; (ii) 'unusual pleasures in sexual relations'; (iii) 'sexual coercion'; (iv) 'verbal violence in sexual relations'; (v) 'self-care in sexual relations'; and (vi) 'concealment in sexual relations' could explain 57.49% of the total observed variance. The findings showed that the 27-item Risky Sexual Behaviour Scale (RSBS-MW) for married women in Iran has excellent internal consistency (α = 0.94) and stability (ICC = 0.98). Health care providers can use it to access risky sexual behaviours in married Iranian women.

Measuring Nurses' Organizational Well-Being: A Systematic Review of Available Instruments

This systematic review aimed to identify and compare instruments measuring nurses' organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses' organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts' similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses' organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.

Development and psychometric evaluation of Sexual and Reproductive Health Assessment Scale for women with educable intellectual disability (SRH-WIDS): a sequential exploratory mixed-method study

BACKGROUND

Women with Intellectual disability have many problems in their sexual and reproductive health due to their special mental and physical conditions caused by disability. This study aimed to develop and evaluate the psychometric properties of Sexual and Reproductive Health Scale for Women with Educable Intellectual disability.

METHODS

This sequential exploratory mixed-method study was conducted at two qualitative and quantitative stages in Tehran, from 2018 to 2020. At the qualitative stage, in-depth and semi-structured interviews were conducted with 21 parents and caregivers of women with intellectual disability to explain the concepts and to generate items. Thereafter, the item pool was formed based on the concepts and themes extracted from the qualitative phase as well as the review of literature. At the second stage, psychometric properties of the scale were assessed. Finally, responsiveness, interpretability, and feasibility of the scale were determined.

RESULTS

An item pool containing 95 items was produced at the first stage. At the second stage, the final version of scale was developed. The psychometric properties of this final version were then assessed and the results showed that the instrument has good validity and reliability. The results of exploratory factory analysis showed that the instrument contains seven factors. Accordingly, these factors explained 53% of the total variance of the instrument variables.

CONCLUSIONS

The results show that the SRH-WIDS with 25 items has sufficient validity and reliability, so it could be easily used by caregivers to assess the sexual and reproductive health of Women with Educable Intellectual disability. Ethical code: IRI.TUMS.VCR.REC 1397.340.

How nurses and midwives engage with patient experience data to inform person-centred quality and safety improvements

AIMS AND OBJECTIVES

To explore how nurses and midwives engage with patient experience data collected via a mobile health app to inform person-centred practice improvements.

BACKGROUND

A large amount of data is collected in healthcare, yet there is limited evidence outlining how nursing and midwifery staff utilise patient experience data to inform person-centred quality and safety improvements.

METHODS

This study utilised action research, underpinned by Practice Development methodology and has been reported using the SQUIRE 2.0 checklist. Six clinical units (medical short stay, acute medical, surgical, oncology/haematology, day surgery and maternity) in a large health district in Australia engaged in three cycles of data collection using a mobile health app. The app captured patient experience data relating to the person-centred KPIs developed and tested by McCance et al. (2012). Staff used the data to develop and evaluate person-centred practice.

RESULTS

A number of improvements in scores and practice occurred through engaging with the data in a cyclical way. All six clinical units saw an improvement in four or more of the KPIs in the patient survey results from cycle one to cycle three, with two clinical units improving in all eight. On average across the six units, there was also an increase in time nurses/midwives were visible to their patients, an increase in clinical documentation reflecting the patients' needs and what was important to them, an increase in positive comments and a decrease in negative comments in patient stories.

CONCLUSION

This study shows that collecting and utilising data from the person-centred KPIs in a collaborative and cyclical way lead to enhanced patient experience and the development and implementation of person-centred quality and safety improvements.

RELEVANCE TO CLINICAL PRACTICE

Capturing and utilising data that are meaningful to nursing/midwifery teams in a cyclical, action-orientated approach result in person-centred practice improvements that enhance the experience of those that are receiving and delivering patient care.

The workplace culture in addiction psychiatry in Finland as described by healthcare personnel

Purpose

The purpose of this study is to describe the workplace culture and factors associated with it from the viewpoint of the personnel providing care to patients with dual diagnosis.

Design/methodology/approach

Data were collected from six organizations using an electronic survey in 2019. The respondents (n = 75) worked in addiction psychiatry in specialized health care and provided care to patients. The data were statistically analyzed.

Findings

Workplace culture was evaluated as positive. Stress was experienced occasionally (Md = 2.58, Q1 = 1.96, Q3 = 3.03), job satisfaction levels were moderate (Md = 4.83, Q1 = 4.28, Q3 = 5.44) and the practice environment was evaluated as neutral (Md = 4.46, Q1 = 4.00, Q3 = 5.04). Gender, age in years, employment relationship, work time, staffing, number of patients and the participants’ experience in health care and experience in their current workplace had statistically significant associations with workplace culture.

Originality/value

In Finland, there have been attempts to reform service structures that also influence mental health and substance addiction services. Workplace culture is one approach to promote service development. Yet, there has been no research on workplace culture in the context of the care of patients with dual diagnosis. The results of this study bring knowledge about how health-care personnel perceives stress, job satisfaction and their practice environment in addiction psychiatry, which can be used to further develop services and workplace culture.

Challenging and redesigning a new model to explain intention to leave nursing

BACKGROUND

It is important to have a full and detailed understanding of the factors that influence intention to leave nursing. It has been shown to be the best predictor of actual turnover, and turnover has a significant financial impact and also on the provision of care.

AIMS

The aim is to examine the impact of predictive work environment factors on nurses' intention to leave their position and to explore contributing factors.

METHODS

Cross-sectional survey using a convenience sample (n = 605) of Finnish nurses drawn from five clinical settings. The Nursing Context Index, an internationally used and psychometrically validated tool, was used to measure workplace practice environment, work stress, job satisfaction and intention to leave. A response rate of 29.4% was achieved, exceeding power calculation estimates.

RESULTS

Personal satisfaction and satisfaction with profession and resources, and organisational commitment were significantly related to intention to leave. Younger nurses reported higher levels of intention to leave and there was variability among clinical specialties. Measures of stress and practice environment had no significant relationship with intention to leave.

DISCUSSION

This study provides a new theoretical model for understanding intention to leave. Having a better understanding of the factors that may help reduce intention to leave allows for targeted interventions to be developed and implemented. This would help reduce the personal and financial implications associated with turnover.

IMPLICATIONS FOR PRACTICE, POLICY, MANAGEMENT AND EDUCATION

The findings have significant implications for all aspects of nursing. Educators need to prepare new nursing staff for the working environment; policymakers must ensure that nursing satisfaction is promoted to strengthen organisational commitment and nurse managers and leaders respond accordingly in implementing effective interventions.

Implementing a Transition-to-Practice Program for Novice Clinical Nurse Specialists: A Pilot Project

PURPOSE

The aim of this study was to determine the impact of a transition-to-practice program on job satisfaction among novice clinical nurse specialists (CNSs) in the US Air Force.

PROGRAM DESCRIPTION

A needs assessment was conducted among currently practicing Air Force CNSs (n = 30) to establish the necessity for a transition-to-practice program. Newly graduated CNSs (n = 8) were paired with experienced CNS mentors and met every 2 weeks for 2 months to discuss progress on the CNS core competencies. Before beginning the program, mentees self-reported perceptions related to the core competencies. Mentors focused on areas of self-reported low competency. The Nursing Context Index was administered preintervention and postintervention to assess the program's impact on job satisfaction.

OUTCOMES

Overall job satisfaction among novice CNSs improved from 5.01 to 5.57 (scale, 1-7) after completing the program. Personal satisfaction (4.30-5.63) and satisfaction with professional support (5.28-6.00) showed the greatest improvement out of the 4 elements of job satisfaction evaluated.

CONCLUSIONS

Transition-to-practice programs can be beneficial for novice CNSs in establishing their practice. Future studies with larger sample sizes over longer periods of time are necessary to determine the true impact of similar programs.

The association of job satisfaction and burnout with individualized care perceptions in nurses

Background:

Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing.

Objective:

This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey.

Research design:

A cross-sectional correlational survey design.

Participants and research context:

The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used.

Ethical considerations:

Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants.

Findings:

There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased.

Discussion:

Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account.

Conclusion:

Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.

Evaluating Nurses' Perception of Patient Safety Design Features in Intensive Care Units

A methodological study was conducted to test the validity and reliability of the patient safety (PS) scale developed by Rashid (2007) for evaluating nurses' perception of adult intensive care unit (ICU) design features related to patient safety. Data for the study were collected using a Web-based survey instrument. A link to the survey instrument was posted on the Web site of American Association of Critical-Care Nurses (AACN) for ICU nurses in different US states to participate. A sample of 587 valid responses was divided into 2 halves for cross-validation. The first half of the sample was used for exploratory factor analysis and the second half for confirmatory factor analysis. This method was applied to identify any latent factor structure in the PS scale. Based on the factor analyses, 4 relevant PS subscales-Efficient Work Process, Patient Room, Accessibility and Visibility, and Maintain Sterility-were identified. These PS subscales were used to investigate whether ICU unit characteristics, nurse characteristics, and hospital type affected nurses' perception of ICU design features in relation to patient safety. The study shows that nurses' perception of ICU design features related to patient safety can be influenced by such factors as nurse characteristics and unit characteristics. When using the scales, therefore, the designers can be aware of the influence of these external factors on nurses' perception. It is hoped that the PS subscales evaluating nurses' perception of ICU physical environmental features related to patient safety would help designers and health care personnel make better ICU design choices.

Measuring nurses' perception of work environment: a scoping review of questionnaires

Background

Nurses’ work environment has been shown to be associated with quality of care and organizational outcomes. In order to monitor the work environment, it is useful for all stakeholders to know the questionnaires that assess or evaluate conditions for delivering nursing care. The aim of this article is: to review the literature for assessed survey questionnaires that measure nurses’ perception of their work environment, make a brief assessment, and map the content domains included in a selection of questionnaires.

Methods

The search included electronic databases of internationally published literature, international websites, and hand searches of reference lists. Eligible papers describing a questionnaire had to be; a) suitable for nurses working in direct care in general hospitals, nursing homes or home healthcare settings; and b) constructed to measure work environment characteristics that are amenable to change and related to patient and organizational outcomes; and c) presented along with an assessment of their measurement properties.

Results

The search yielded 5077 unique articles. For the final synthesis, 65 articles met inclusion criteria, consisting of 34 questionnaires measuring nursing work environments in different settings. Most of the questionnaires that we found were developed, and tested, for registered nurses in a general hospital setting. Six questionnaires were developed specifically for use in nursing home settings and one for home healthcare. The content domains covered by the questionnaires were both overlapping and unique and the terminology in use was inconsistent. The most common content domains in the work environment questionnaires were supportive managers, collaborative relationships with peers, busyness, professional practice and autonomy.

Conclusions

The findings from this review enhance the understanding of how “work environment” can be measured by an overview of existing questionnaires and domains. Our results indicate that there are very many work environment questionnaires with varying content.

Electronic supplementary material

The online version of this article (10.1186/s12912-017-0256-9) contains supplementary material, which is available to authorized users.

Workplace culture in psychiatric nursing described by nurses

AIM

This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment.

METHODS

Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed.

RESULTS

Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture.

CONCLUSION

Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred.

Psychometric testing of the Slovenian Person-centred Climate Questionnaire - staff version

AIM

To test the psychometric properties of the Slovenian version of the Person-centred Climate Questionnaire - staff version.

BACKGROUND

Person-centredness can be a quality care indicator, but there are no valid and reliable instruments in the Slovene language aimed at exploring the person-centred care climate from a nursing staff perspective.

METHODS

Content validity based on expert agreement was evaluated by calculating content validity indices. A cross-sectional survey design using a convenience sample of 790 nurses and nursing assistants from medical and surgical wards in 11 hospitals was used to test the construct validity and internal consistency reliability.

RESULTS

The average content validity index for the scale was 0.97, all items had content validity indices higher than 0.78, showing satisfactory content validity. Three components, climate of safety, community and everydayness explained 71.22% of the variance in the data and thus confirmed scale dimensionality. Cronbach's α was acceptable for whole scale (0.90) and for subscales (0.89, 0.89 and 0.86).

CONCLUSION

The Slovene version of the Person-centred Climate Questionnaire - staff version is valid and reliable and can be further used in surgical and medical wards in hospital settings.

IMPLICATION FOR NURSING MANAGEMENT

The instrument enables further exploration of the relationships between perceived person-centredness and organisational outcomes.

Developing nurse and physician questionnaires to assess primary work areas in intensive care units

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

Performance of the measures of processes of care for adults and service providers in rehabilitation settings

Introduction

In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts.

Objective

The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)).

Design

A validation study

Settings

In-patient rehabilitation facilities.

Main outcome measures

MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)).

Results

Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71–0.88 for health care professionals, 0.82–0.90 for patients, and 0.87–0.94 for family members), as well as moderate to good correlations between domains (0.40–0.78 for health care professionals and 0.52–0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire.

Conclusion

MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

A longitudinal study of aspects of a hospital's family-centred nursing: changing practice through data translation

AIMS

To examine how results and data from multiple Family Centred Nursing Index surveys help the development of family-centred nursing at organizational and ward levels.

DESIGN

A critical analysis of survey data.

BACKGROUND

The Family Centred Nursing Index provides a valid and reliable assessment of aspects of nursing, through a comprehensive survey of traditional indicators of practice development and a broader range of aspects of practice.

METHODS

A survey with 113 questions, each to be answered on 7-point Likert scale conducted six times in the last 7 years. Surveys have been in 2006, 2008, 2009, 2010, 2011/2012 and 2012/2013. All nurses employed by the organization can participate.

RESULTS

These are reported as means across 19 constructs linked to five key domains and their significance is examined by year and (in the clinical settings) and compared against the organizational (whole population) averages. Ongoing survey and analysis of nurses' views of their work is providing a valuable source of developmental data. The results show unexpected associations between constructs e.g. - a high level of work stress does not correlate with a lower level of job satisfaction (and vice versa). A clear historical picture of many elements of developing family-centred care is emerging at both the organizational and individual-ward levels.

CONCLUSION

This study provides insights into aspects of organizational and wards working environment for nurses and how these aspects of nurses' work interact in unexpected ways. It is appropriate for providing information to organizations and ward teams in relation to their development towards family-centred cultures.

Ontological Security in Nursing Homes for Older Persons - Person-Centred Care is the Power of Balance

INTRODUCTION

The Swedish national guidelines for elderly care describe how older persons should be able to trust that their care is permeated with security. Different theoretical perspectives can be found that describe what creates security. Many studies have been done about security. However, few studies have explicitly asked older persons what security in nursing homes means to them.

AIM

The aim of the study was to describe how older persons in nursing homes talked and reflected about security in their daily lives.

METHOD

Nine older persons were interviewed in, in-depth interviews one to three times and the resulting data was analysed using content analysis.

RESULTS

The older persons adapted to having their own needs and those of the other older persons met and to the staff routines which created a sense of security. At the same time, they longed for security in which they could trust themselves and create their own daily life. Further to have a sense of belonging and of being liked for created an internal, interpersonal and external security. This can be linked to an ontological security which means having a sense of confidence in the continuity of self-identity and order in events, a being in the world.

CONCLUSION

Person-centred instead of institution- centred care can provide the balance of power that allows the older person to obtain ontological security in which the staff's ability to create a relationship with the older persons becomes crucial.

Caregivers' work satisfaction and individualised care in care settings for older people

AIM AND OBJECTIVES

To examine the association between caregivers' work satisfaction and individualised care in different care settings for older people.

BACKGROUND

Work satisfaction in older people care settings has been associated with absenteeism, staff turnover and the quality of care delivered. The management of individuality is an important quality of care issue. Although these two issues are important there is little evidence about the possible association between them.

DESIGN

An exploratory and correlational survey design.

METHODS

Data were collected using three questionnaires, the Individualised Care Instrument the Individualised Care Scale-Nurse and the Index of Work Satisfaction from a sample of professional nursing caregivers (n=263, response rate 71%) in care settings for older people in one health care area in Finland in 2010. Statistical analysis included descriptive statistics, correlations, analysis of variance and multiple regression analysis.

RESULTS

Caregivers support the patient's individuality through specific activities, perceiving that they maintain individuality in care provision whilst reporting moderate work satisfaction. The ratings of individuality assessments were the lowest in nursing homes followed by long-term care in in-patient wards. There were statistically significant correlations between work satisfaction and specific perceptions in the support of individuality. The sub-scales of the instruments used were: the Support of Individuality in general, Individuality in the Care Provided, Knowing the Person, Staff-to-Resident Communication and Staff-to-Staff Communication. Significant statistical differences in the results were found between staff working in home care, primary health care, in-patient wards and nursing homes.

CONCLUSIONS

Low job satisfaction can affect the provision of individualised care emphasising the need to promote individualised care at an organisational level as a means of improving work satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Instruments to measure work satisfaction and individualised care can be used to improve care quality.

Psychometric evaluation of the Swedish version of the Person-Centered Care Assessment Tool (P-CAT)

BACKGROUND

Person-centered care is a multidimensional concept describing good care, especially within aged care and care for people with dementia. Research studies evaluating person-centered care interventions seldom use direct measurement of levels of person-centeredness. Existing scales that measure person-centeredness need further testing. This study evaluated the psychometric properties of the Swedish version of the Person-Centered Care Assessment Tool (P-CAT).

METHODS

A cross-sectional sample of 1465 staff from 195 residential care units for older people in Sweden participated in the study. Validity, reliability, and discrimination ability of the scale were evaluated.

RESULTS

Confirmatory factor analysis, parallel analysis and exploratory factor analysis supported the construct validity of a two-factor solution. Reliability and homogeneity were satisfactory for the whole P-CAT as demonstrated by a Cronbach's α of 0.75. Test-retest reliability showed temporal stability of the scale, and the discrimination ability of the scale was satisfactory.

CONCLUSION

The Swedish version of the P-CAT was found to be valid, reliable, and applicable for further use. Two subscales are recommended for the Swedish version.