Development and reliability testing of a risk factor and risk outcome assessment scale for nurses in “internet + nursing services” for the elderly

Abstract Background China is experiencing an aging population, leading to a significant demand for “Internet + nursing services” tailored for elderly individuals. However, there are many risk problems in the process of nurse service, which hinder the development of the service, and a scale is needed to assess the risk problems faced by nurses in “Internet + nursing services” for the elderly. Objective The purpose of this study is to develop an assessment scale for risk factors and outcomes related to nurses’ involvement in the “Internet + Nursing Service” for the elderly and to assess its reliability and validity. Methods Based on literature analysis, focus group, the Delphi method, and a presurvey, we designed an initial scale. The initial scale comprised two sections: risk factors and risk outcomes for nurses. In January and February of 2023, nurses engaged in “Internet + nursing services” for the elderly in Shanxi Province were chosen through a convenience sampling technique for a questionnaire survey. Subsequently, item analysis and exploratory factor analysis were employed to refine and develop a test version of the scale further. A follow-up questionnaire survey was carried out in March and April 2023 using a similar approach. The reliability and validity of the scale were assessed through confirmatory factor analysis, culminating in the formation of the final scale. Results The initial survey yielded 244 valid responses. The cumulative variance contributions of the two segments from the exploratory factor analysis were 84.584% and 90.089%, respectively. A subsequent survey garnered 220 valid responses. The confirmatory factor analysis results indicated: χ2/df = 2.086, comparative fit index (CFI) = 0.918, normative fit index (NLI) = 0.855, root mean square of residuals (RMR) = 0.045, and root mean square of error of approximation (RMSEA) = 0.070. These results demonstrate good structural, convergent, and discriminant validity. The content validity index at the item level (I-CVI) ranged between 0.875 and 1.000, while the content validity index at the scale level (S-CVI/Ave) was 0.941. Cronbach’s alpha coefficient for the entire scale stood at 0.970. Moreover, the scale exhibited a split-half reliability of 0.876 and a retest reliability of 0.980 ( p < 0.01). Conclusion The risk factors and risk outcomes associated with nurses involved in “Internet + nursing services” for elderly individuals, as developed in this study, demonstrate strong reliability and validity. They are well suited to the Chinese national context.