Nurse–Physician Collaboration Scale: development and psychometric testing

AIM: This paper is a report of a study conducted to develop and test the psychometric properties of the Nurse-Physician Collaboration Scale. BACKGROUND: The importance of cooperation between healthcare professionals is widely acknowledged in Europe and the United States of America, but there have been no specific studies of interactions between healthcare professionals or of nurse-physician cooperation in Japan. METHODS: The 51-item Nurse-Physician Collaboration Scale was developed using a process of item design, item refinement, and testing for reliability and validity. Random sampling was used to identify potential respondents from 27 of the 87 acute care hospitals in one city in Japan in 2006. Valid responses were obtained from 446 physicians and 1217 nurses (response rate 78.7% for nurses, and 54.4% for physicians). Construct validity was first confirmed by an exploratory factor analysis and then by a confirmatory factor analysis. Finally, a simultaneous analysis of several groups was performed. The test-retest method and Cronbach's alpha coefficients were used to assess reliability. FINDINGS: Exploratory factor analysis yielded three factors. The three-factor models were confirmed by a confirmatory factor analysis (CFI >0.9, RMSEA <0.08). Simultaneous analysis of several groups (RMSEA = 0.046, AIC = 3115.888) showed the same factor structure for both nurses and physicians. The r values of the test-retest reliability correlations were all 0.7 or above. Internal consistency was demonstrated by a Cronbach's alpha = 0.8 or above. CONCLUSION: The Nurse-Physician Collaboration Scale can be used to establish standards for nurse-physician collaboration, to measure the frequency of collaborative activity, and to verify unit-specific relationships between collaboration and quality of care.