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Instrument development for NEAT: Nurses Environmental Awareness Tool
Western Institute of Nursing Annual Communicating Nursing Research Conference (2013)
  • Elizabeth Schenk, Providence St. Joseph Health
  • Celestina Barbosa-Leiker, Washington State University
  • Patricia Butterfield, Washington State University
  • Julie Postma, Washington State University
Purpose/Aims: No psychometrically analyzed instrument that measures nurse awareness of the environmental impacts of nursing practice is available in the literature. The NEAT: Nurse’s Environmental Awareness Tool is being developed. The study has three phases; Item Development Phase, Pilot Phase, and Study Phase. For this presentation, the completed Item Development Phase will be described. Conceptual Basis/Background: There is an increasing awareness that health care delivery may pose long-term health risks to the public through environmental impacts stemming from excessive energy use, the creation of large volumes of waste, and the generation and use of toxic chemicals. Nursing is a major stakeholder in the health delivery system; thus it is critical to understand nurses’ awareness of and engagement with the environmental impact of their practice. A pool of items (160) was developed using two conceptual frameworks. The Integrated Change Model links awareness to behavior change (deVries et al., 2003). The EWTE Wheel describes four domains of environmental impacts to be addressed; energy, waste, toxic chemicals and engagement (Schenk, 2011). Based on these directives, a pool of items linking awareness to behavior in the four domains described was developed. Methods: Seven content experts from across the nation were interviewed. Each had an interest in environmental health, and several were experienced psychometricians. Interviews were conducted by phone; comments were utilized to adapt item pool. Notes were kept and findings were reported anonymously. Findings: Based on content expert feedback, several significant content changes from the original item pool were made. In addition, an innovative two-part question format was developed to address challenges uncovered in the interview process. Resulting from this phase of development, is a draft NEAT of 48 two-part items and 18 demographic items. The items are organized in three subscales; nurse professional ecological behaviors, personal ecological behaviors, and nurse awareness. Each includes a two part question. For the behavior scales, the first part asks about how frequently a nurse carries out a particular behavior (such as recycling), and the second asks the nurse to rank how easy or difficult it is to perform that behavior. For the nurse awareness scale, the first part asks about awareness of a particular evidence supported environmental impact of nursing practice (such as plasticizers used in healthcare equipment are hormone disruptors) and the second part asks the nurse to rank how related it is to health impacts. Summary: The NEAT: Nurses Environmental Awareness Tool will be the first psychometrically analyzed instrument to measure nurses’ awareness of the environmental impacts of nursing practice, with opportunities to study links between awareness and behaviors. The first phase of instrument development, the Item Development Phase, is described here. Reported is a description of interviews with content experts, findings from those interviews and resultant changes in the item pool, leading to preparation of the Draft NEAT, to be used in factor analysis for development of the instrument.
Publication Date
April, 2013
Anaheim, CA, United States
Citation Information
Elizabeth Schenk, Celestina Barbosa-Leiker, Patricia Butterfield and Julie Postma. "Instrument development for NEAT: Nurses Environmental Awareness Tool" Western Institute of Nursing Annual Communicating Nursing Research Conference (2013)
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