Development and Psychometric Evaluation of the Moral Commitment Scale for Thai Baccalaureate Nursing Students (MCS-Thai)

Abstract

This study aimed to develop the Moral Commitment Scale for Thai Baccalaureate Nursing Students (MCS-Thai) and evaluate its psychometric properties. The scale development process consisted of two phases: (1) the development of the MCS-Thai. Focus group discussions and literature reviews were used to generate 138 items with a 5-point Likert-scale format and (2) the psychometric evaluations of the MCS-Thai. Content validity index of the MCS-Thai was examined by five experts. The item-level content validity index (I-CVI) ranged from 0.8-1.0. The scale content validity index with universal agreement (S-CVI/UA) was .90 and scale content validity index with average (S-CVI/Ave) was 92. To determine its internal consistency using Cronbach's alpha coefficient reliability, the result was .98. The MCS-Thai was administered to 809 senior baccalaureate nursing students from 10 nursing schools in Thailand. Exploratory factor analysis (EFA) with varimax rotation was performed. The result of EFA was six factors which comprised 81 items. The six factors were labeled as: (1) respect patient's privacy and keeping patient's information confidential (22 items), (2) respect for patients (25 items), (3) providing care equally to each patient (9 items), (4) causing no harm to patients (12 items), (5) doing good for patients (8 items), and (6) telling the truth to patients and healthcare team (5 items). It accounted for 47.7% of variance and factor loadings ranged from .45-68. The internal consistency was determined, yielding an alpha coefficient of .98 for the total scale and ranged from 84-95 of each factor. Hypothesis testing supported construct validity (r = .54, p < .01). The stability reliability of the scale was examined by test-retest method and supported with high correlation (r = .77, p < .01). The MCS-Thai is a valid and reliable instrument which can be used by nursing schools to assess moral commitment of nursing students in order to design nursing education for moral cultivation which will result in high quality nursing practice.