Development, reliability, and validity of the nurses’ conscientious objection attitude scale (COAS-N)
BMC Medical Ethics, vol.25, no.1, 2024 (SCI-Expanded, SSCI, Scopus)
- Publication Type: Article / Article
- Volume: 25 Issue: 1
- Publication Date: 2024
- Doi Number: 10.1186/s12910-024-01155-4
- Journal Name: BMC Medical Ethics
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, IBZ Online, CINAHL, EMBASE, MEDLINE, Psycinfo, Directory of Open Access Journals
- Keywords: Conscientious objection, Ethics, Nursing care, Refusing to care, Reliability, Scale development, Validity
- Gazi University Affiliated: Yes
Abstract
Background: Conscientious objection poses ethical dilemmas frequently encountered by nurses, allowing them to prioritize personal beliefs in caregiving. However, it may also be viewed as a stance jeopardizing patients’ healthcare access. There is no measurement tool to measure conscientious objection in nurses. This study aimed to develop a measurement tool for nurses’ conscientious objection attitudes. Methods: This research is a methodological study conducted with a total of 261 nurses in Turkiye. Following content validity assessments by ten experts, a 29-item draft scale was developed. Exploratory and confirmatory factor analyses examined the factor structure, and reliability was assessed via the Spearman-Brown coefficient, intraclass correlation coefficient (ICC), and Bland Altman plot. Cronbach’s alpha estimated internal consistency and discrimination, which were evaluated by comparing lower and upper 27% groups. Results: The Nurses’ Conscientious Objection Attitude Scale (COAS-N) comprises 29 items and three sub-dimensions (prioritizing professional values, prioritizing personal values, and requesting the right to conscientious objection). Cronbach’s alpha for the entire scale is 0.81. Conclusion: Validity and reliability were established for the newly developed scale measuring nurses’ conscientious objection attitudes.