Development and psychometric testing of the Pediatric Atraumatic Care Attitude Scale (PACAS) in pediatric nurses

Abstract

Objective: The study aimed to develop and validate the Pediatric Atraumatic Care Attitude Scale (PACAS) for pediatric nurses, measuring attitudes toward atraumatic care practices. Methods: This methodological and correlational study included 336 pediatric nurses from various clinics in Turkey, between January and August 2024. Construct validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through item-total score correlation, test-retest reliability, and Cronbach's α coefficients. Results: The content validity index (CVI) for PACAS items ranged from 0.84 to 1.00. The Kaiser-Meyer-Olkin (KMO) coefficient was 0.978, and Bartlett's test of sphericity was significant (χ2 = 14,110.425, P < .001), supporting factor analysis. EFA revealed a two-factor structure with 31 items, explaining 76.7 % of the variance. The factors, “Knowledge and Awareness” and “Practice and Family Involvement,” had loadings between 0.716 and 0.901 and 0.751–0.962, respectively. CFA confirmed the model fit (χ2/df = 2.77, RMSEA = 0.073, NFI = 0.92, NNFI = 0.97, CFI = 0.94, GFI = 0.91). Cronbach's α was 0.985, with subscale coefficients of 0.978 and 0.983. Test-retest reliability showed strong correlations (r = 0.980, r = 0.985, r = 0.957), with no significant differences between test and retest scores (P > .05). Conclusions: PACAS is a reliable and valid tool for assessing pediatric nurses' attitudes toward atraumatic care, with the potential to enhance pediatric nursing practices by improving adherence to atraumatic care principles. Implications to practice: PACAS helps integrate atraumatic care into nursing, enhancing pediatric care quality and outcomes. © 2024 Elsevier Inc.