Reliability and validity of the Chinese version of the family presence risk-benefit and self-confidence scales in Chinese nurses

Abstract

Background: Controversy surrounding Family Presence during Resuscitation (FPDR) continues internationally. The attitudes of medical professionals toward FPDR are particularly important for its clinical implementation. Currently, there is a lack of validated tools to evaluate medical professionals' perceptions of FPDR in China. The study aimed to: (1) Cross-culturally adapt and validate the Family Presence Risk-Benefit Scale (FPR-BS) and the Self-Confidence Scale (FPS-CS) for use in China; and (2) investigate the nurses' perceptions of FPDR and explore the relationships between the nurses' perceptual variables and demographic variables.

Methods: The English version of the FPR-BS and FPS-CS underwent a rigorous process of translation, back-translation, proofreading, and cultural adaptation to create the Chinese versions. In the first stage, a sample of 200 nurses were recruited to evaluate the reliability and validity of the scales. In the second stage, a larger cohort 519 nurses were invited to assess their perceptions of FPDR and the relationships between these perceptual variables and demographic variables.

Results: Exploratory factorial analysis identified a single dimension for both the FPR-BS and FPS-CS, explaining 43.84% and 48.43% of the variance, respectively. The Scale-level content validity index (S-CVI) of the FPR-BS and the FPS-CS was 0.98 and 0.97, respectively. Reliability assessments yielded Cronbach's alpha coefficients of 0.933 for the FPR-BS and 0.930 for the FPS-CS. The split-half reliability coefficients were 0.832 for the FPR-BS and 0.835 for the FPS-CS, while the retest reliability coefficients were 0.742 and 0.927, respectively. The average scores obtained were 2.76 (SD = 0.52) for the FPR-BS and 3.43 (SD = 0.58) for the FPS-CS. Statistical analyses revealed that factors such as patient type, family members' prior experience with resuscitation, and the number of times nurses invited family members during resuscitation significantly influenced perceptions of the benefits and risks associated with FPDR (P < 0.05). Furthermore, obtaining certification as an intensive care specialist was positively associated with nurses' self-confidence in managing FPDR (P < 0.05).

Conclusions: The FPR-BS and FPS-CS were validated as effective instruments for measuring nurses' perceptions of PFDR, demonstrating acceptable levels of validity and reliability. While nurses reported fewer benefits and greater risks of FPDR, they exhibited increased self-confidence in managing family presence during resuscitation.

Keywords: Family Presence during Resuscitation; Nurses; Resuscitation; Validation.