Peer-reviewed article
Development and initial psychometric evaluation of nurturing care knowledge and attitude scales among mothers of hospitalized children
Suprihatiningsih Suprihatiningsih, Ayyu Sandhi, Sri Hartini, Lely Lusmilasari, Novi Rohmawati et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study developed and tested two measurement scales to assess mothers' knowledge and attitudes about nurturing care for hospitalized children aged 6-59 months in Indonesia. The knowledge scale contained 16 items and the attitude scale contained 20 items, both adapted from existing community-based instruments. The scales showed strong validity and reliability in initial testing with 105 mothers, though the researchers note they need further testing with larger and more diverse groups.
Key points
- The knowledge instrument showed good content validity (I-CVI = 1.00, CVR = 1.00) and adequate internal reliability (KR-20 = 0.646)
- The attitude instrument demonstrated excellent internal consistency (Cronbach's alpha = 0.885) and partial support for its four-factor structure
- 14 of 16 knowledge items showed adequate item discrimination with point-biserial correlations ranging from 0.319–0.547
- The study addresses a measurement gap in pediatric nursing for assessing maternal nurturing care knowledge and attitudes in hospital settings
- Instruments were tested only with mothers of hospitalized children in one tertiary pediatric ward in Yogyakarta
Limitations
This is an instrument development study, not an evaluation of an intervention's effectiveness for child outcomes. The sample was limited to one hospital setting in Indonesia, and the authors explicitly state the instruments require further validation in larger and more diverse populations before wider use.
Abstract
Introduction: This study aimed to conduct an initial psychometric evaluation of knowledge and attitude instruments, modified from existing validated community-based Nurturing Care instruments, measuring maternal knowledge and attitudes Methods: A methodological study with a cross-sectional psychometric validation design was conducted in three consecutive phases: (1) modifications of the instrument and content validation, (2) construct validation, and (3) assessment of reliability. A total of 105 mothers of children aged 6–59 months were recruited from the tertiary pediatric ward in Yogyakarta, Indonesia. To evaluate content validity, the Item-level Content Validity Index (I-CVI) and Content Validity Ratio (CVR) were computed. Knowledge items were evaluated for item discrimination using point-biserial correlation, and the attitude construct was evaluated using Confirmatory Factor Analysis (CFA) under a four-factor model. Results: The tools demonstrated excellent content validity (I-CVI = 1.00, CVR = 1.00, and S-CVI/Ave = 1.00). The knowledge instrument comprised 16 items and demonstrated adequate item-level discrimination, with 14 of the 16 items showing point-biserial correlations (rpb = 0.319–0.547) and a KR-20 of 0.646. The attitude instrument comprised 20 items and, following model revision, showed partial support for the hypothesized four-factor structure (χ²/df = 1.867, SRMR = 0.048, CFI = 0.874, TLI = 0.837, RMSEA = 0.091), with excellent internal consistency (Cronbach's alpha = 0.885). Conclusions: The instruments provide preliminary psychometric evidence to address an important measurement gap in pediatric nursing regarding maternal knowledge and attitudes towards Nurturing Care during child hospitalization, and they require further validation in larger and more diverse samples.