Development and validation of a rating scale for barriers and facilitators of nurses' participation intention on “Internet + nursing service”

Abstract Background: With the increasing pace of China's aging population, the growing demand for public health services and the shortage of nursing human resources have become more prominent. The “Internet+ Nursing Services” have received more attention. Exploring the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services” and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services”, and to test the validity and reliability of the scale. Methods: A preliminary scale was developed through literature review, theoretical research, semi-structured qualitative interviews, and two rounds of Delphi expert inquiry. A convenience sampling method was used for the questionnaire survey. Likert 5-point scoring was used to assign importance to the items. The survey data of 659 clinical nurses from February to March 2023 were used for item analysis, exploratory factor analysis, and reliability and validity tests of the pre-test scale. The survey data of 538 clinical nurses in April 2023 were used for confirmatory factor analysis of the formal scale. Results: The final scale consisted of 25 items and 4 dimensions (performance expectation, perceived risk, professional knowledge training needs, and non-professional knowledge training needs). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the KMO value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The content validity index of the scale (S-CVI) was 0.914. The confirmatory factor analysis model fit indices were good: χ2/df=4.234, RMSEA=0.078, NFI=0.940, IFI=0.953, TLI=0.947, and CFI=0.953. Conclusion: The scale for assessing the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services” has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in “Internet+ Nursing Services”.