Development and Psychometric Evaluation of Nurses’ Ethical Acceptance of Artificial Intelligence Scale in Clinical Practice

Nurses, frontline providers, must ethically adopt AI in care, but no validated tool exists to assess their ethical acceptance. This study aims to develop and evaluate the Nurses' Ethical Acceptance of Artificial Intelligence Scale (NEAIS). A methodological study was conducted in 2 phases between August 2024 and May 2025. In phase I, an item pool was developed based on ethical awareness theory and the Unified Theory of Acceptance and Use of Technology. Content validity was confirmed through expert review. A sample of 266 nurses completed the scale, and exploratory factor analysis (EFA) was conducted. In phase II, 221 nurses participated in CFA and Rasch modeling to validate the scale's structure and item functioning. EFA revealed 2 factors: (1) ethical awareness and comfort, and (2) ethical action and responsibility. CFA supported this, showing good fit and internal consistency (α = 0.74, ω = 0.77). Rasch analysis confirmed item reliability and person separation. The final scale has 15 items with strong psychometric properties. The NEAIS is a reliable, valid tool for assessing nurses' ethical acceptance of AI in clinical practice, helping evaluate readiness and guide ethical AI implementation in health care. Future research should test its use across different cultures and countries.