Environmental Risk Assessing Instrument–Occupational Low Back Pain in Nurses (ERAI-N)

Abstract

The Environmental Risk Assessing Instrument–Occupational Low Back Pain in Nurses (ERAI-N), developed by Zhang, Liu, & Yuan in 2023, was created to serve as a tool for clinical administrators in measuring the risk factors associated with low back pain among nurses in the intensive care unit (ICU). The development process began with an initial pool of 27 items, which were generated from a qualitative study that utilized focus group interviews and a literature review, all guided by human factors theory. To assess content validity, an expert review process based on the Delphi method (1986) was employed, which resulted in a refined 20-item scale. Following this, a pre-investigation was conducted within the ICUs of tertiary medical institutions in China to further screen the items of this initial scale. The final measure was completed by ICU nurse administrators at tertiary general hospitals located in China. A confirmatory factor analysis was performed, which supported the hypothesized five-factor structure, and a final total of 18 items were retained for the instrument. The results also reported on the measure’s reliability and validity.

Keywords

Atmosphere of Safe Culture; Back Pain; Belief; Environmental Risk Factors; Equipment; Guideline; Health Care Personnel Measures; Hospital Environment; Intensive Care Unit Nurses; Nurses; Occupational Low Back Pain; Organizational Climate; Risk Assessment; Risk Factors; Space; Working Conditions

Authors

Zhang, Lihui; Liu, Yangyang; Yuan, Su’e

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Purpose

The purpose of this measure is to assess environmental risks leading to low back pain in ICU nurses.

Construct

Occupational Low Back Pain in Nurses

Validity

Content validity was established with item-level CVI results ranging from 0.89 to 1.0, which is greater than the recommended 0.78 threshold. Construct validity was assessed using confirmatory factor analysis.

Reliability

The instrument demonstrates strong reliability. For internal consistency, Cronbach’s alpha scores for the instrument’s five factors ranged from 0.793 to 0.982, with the overall scale achieving a score of 0.963. Guttman split-half scores were found to be between 0.708 and 0.928. The McDonald’s omega reliability coefficient ranged from 0.866 to 0.986. For test-retest reliability, the Intraclass Correlation Coefficient (ICC) scores for the factors ranged from 0.616 to 0.924, and the scale’s overall ICC was 0.994.

Factor Analysis

A confirmatory factor analysis was conducted. In the initial model, the χ²/df was approximately 5, and neither the IFI nor CFI values met the ≥ 0.9 threshold. After several adjustments to the model and group discussions, two items were deleted. The final five-factor hypothesized adjusted model demonstrated an acceptable model fit. All parameters within the model were statistically significant at p < 0.001. The goodness-of-fit indices for the final model were as follows: chi-square statistic and degrees of freedom (χ²/df) = 3.943, root mean square error of approximation (RMSEA) = 0.071, incremental fit index (IFI) = 0.905, comparative fit index (CFI) = 0.904, parsimony normed fit index (PNFI) = 0.641, and parsimonious comparative fit index (PCFI) = 0.661. The standardized factor loadings ranged from 0.567 to 0.974, all of which exceeded the recommended 0.40 threshold. The five factors identified are: Space; Equipment; Belief; Guideline; and Atmosphere of safe culture.

Instrument: Test Type , Format , Language Available , Population Group, Age Group, Population Details and Test Methodology

Test Type: Original
Format: This instrument is an inventory/questionnaire that utilizes a 5-point Likert-type scale for responses, ranging from 1 (very inconsistent) to 5 (very consistent).
Language Available: English
Population Group: Human
Age Group: Adulthood (18 yrs & older)
Population Details: The measure was completed by ICU nurse administrators working in tertiary general hospitals in China.
Test Methodology: Test Validity; Construct Validity; Content Validity; Test Reliability; Internal Consistency; Test-Retest Reliability; Factor Analysis; Confirmatory Factor Analysis.

Keywords

Atmosphere of Safe Culture; Back Pain; Belief; Environmental Risk Factors; Equipment; Guideline; Health Care Personnel Measures; Hospital Environment; Intensive Care Unit Nurses; Nurses; Occupational Low Back Pain; Organizational Climate; Risk Assessment; Risk Factors; Space; Working Conditions

Authors including Author ocrid Identifier and Affiliation Email addresses Correspondence Address

Zhang, Lihui

• Affiliation: Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University

• Email: No data is Available

Liu, Yangyang

• Author Identifier: http://orcid.org/0000-0003-1756-4788

• Affiliation: Xiangya Nursing School, Central South University

• Email: No data is Available

Yuan, Su’e

• Affiliation: Teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University

• Email addresses: [email protected]

• Correspondence Address: Yuan, Su’e: [email protected]

Permissions & Fee and Test Year

Permissions: May be used for Research/Teaching.
Web Site: https://creativecommons.org/licenses/by/4.0/
Commercial: No
Fee: No
Test Year: 2023

Reference’s

Zhang, L., Liu, Y., & Yuan, S. (2023). Environmental risk assessment of low back pain in ICU nurses: An instrument development study. Journal of Nursing Management, 2023, Article 3649293. https://doi.org/10.1155/2023/3649293

Items of the Environmental Risk Assessing Instrument–Occupational Low Back Pain in Nurses (ERAI-N)

This measure consists of 18 items. The full list of test items is available in the source reference article, specifically in Table 5 on page 7.

Each item of the scale is rated using a Likert-type scale with five response options: very inconsistent = 1, not very consistent = 2, uncertain = 3, fairly consistent = 4, and very consistent = 5.