Development and testing of an instrument to assess nurses' knowledge, risk perception, health beliefs and behaviours related to influenza vaccination

Aims and objectives. To develop an instrument to measure nurses knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours and evaluate its construct validity and internal consistency reliability. Background. Although instruments to assess predictors of nurses vaccination behaviours have been developed, their validity and reliability have not been reported. Design. Instrument development and initial validity and reliability testing. 

Methods. The instrument was developed drawing on a literature review and expert consultation and was refined through pilot work. A cross-sectional survey using a revised version of the instrument was conducted among a convenience sample of 520 registered nurses (response rate 77.4%). Cronbachs alpha coefficient was calculated to determine internal consistency of the sub-scale in the instrument. Principal components analysis with varimax rotation was carried out to evaluate the instruments construct validity and examine its internal structure. 

Results. Cronbachs alpha coefficients for the three newly developed scales ranged from 0.700.76. Principal components analysis produced a good fit and confirmed the internal design of the instrument. In the seasonal influenza knowledge sub-scale four factors explained 44.8% of the total variance; in the H1N1 knowledge sub-scale two factors explained 44.7% of the total variance. Three factors in the risk perception scale contributed 50.5% of the total variance and two factors in the vaccination behaviours scale contributed 62.1% of the total variance. 

Conclusions. An instrument has been developed to assess nurses knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The instrument was valid and reliable for the setting where it was used. Relevance to clinical practice. This instrument could be used to assess nurses knowledge, risk perception, health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The three newly developed scales could also be used independently to measure variables influencing nurses vaccination practices.