Development, reliability, and validity of the nurses' conscientious objection attitude scale (COAS-N)

BMC Med Ethics. 2024 Dec 21;25(1):147. doi: 10.1186/s12910-024-01155-4.

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.

Keywords: Conscientious objection; Ethics; Nursing care; Refusing to care; Reliability; Scale development; Validity.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Conscience*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurses* / psychology
  • Psychometrics
  • Refusal to Treat / ethics
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Young Adult