Validation and Psychometric Evaluation of the Persian Version of the Nurse Intuition Patient Deterioration Scale: A Methodological Study

Aim Early recognition and intervention in cases of clinical deterioration are essential to preventing significant harm to patients, with nurses playing a crucial role in this process. The Nurse Intuition Patient Deterioration Scale (NIPDS) was developed to assess various aspects of a patient's condition, enabling nurses to identify potential issues even when vital signs do not indicate an urgent concern. This study aims to validate the Persian version of the NIPDS (NIPDS‐P) and assess its psychometric properties based on the assessments of 250 hospitalized patients whose clinical status was evaluated by clinical nurses in Iran. Design A two‐phase validation process involved the NIPDS‐P ratings completed by clinical nurses for 250 hospitalized patients from multiple departments, including general wards, intensive care units, and emergency departments. The nurses completed the NIPDS‐P for each patient based on their intuitive clinical assessment. Methods The study assessed the scale's reliability, construct validity, and face validity through quantitative and qualitative methods following COSMIN guidelines. Results The content validity was confirmed by experts, as indicated by a Content Validity Index (CVI) of 0.92 and a Content Validity Ratio (CVR) exceeding 0.99. The NIPDS‐P exhibited high internal consistency, with both Cronbach's Alpha and McDonald's Omega values exceeding 0.95. Exploratory factor analysis (EFA) was conducted using the common‐factor method with maximum likelihood extraction, which supported a unidimensional structure (one factor, eigenvalue = 6.567, explaining 72.97% of the variance). Confirmatory factor analysis (CFA), employing the diagonally weighted least squares (DWLS) estimator with polychoric correlations, confirmed this structure, yielding acceptable fit indices: CFI = 0.980, TLI = 0.975, RMSEA = 0.078 (90% CI [0.054, 0.102]), and SRMR = 0.041. Conclusion The NIPDS‐P is reliable and valid for evaluating nurse intuition regarding patient deterioration in Iran. While its strengths highlight its potential to enhance nursing practice, further research is needed to explore its applicability in broader clinical settings and diverse patient populations. The high alpha (0.96) may indicate some item redundancy, and the cut‐off score of ≥ 5 should be considered provisional pending ROC analysis against objective clinical outcomes.