Psychometric testing of the caring assessment tool: Administration (CAT-Adm©)

Objectives The overall purpose of this study was to evaluate the validity and reliability of the Caring Assessment Tool-Administration survey. Three specific aims were to (1) evaluate construct validity of the Caring Assessment Tool-Administration survey by testing the hypothesized eight-factor structure of staff nurses' perceptions of nurse manager caring behaviors, (2) estimate the internal consistency, and (3) conduct item reduction analysis. Methods A 94-item Caring Assessment Tool-Administration designed to assess nurse manager caring behaviors appeared in the literature but lacked robust psychometric testing. Using a foundational theory and a cross-sectional descriptive design, the Caring Assessment Tool-Administration was evaluated for reliability and construct validity. Using convenience sampling, 1143 registered nurses were recruited from acute care hospitals in three states located in the Midwestern, Mid-Atlantic, and Southern Regions of the United States. Results Psychometric testing of the Caring Assessment Tool-Administration was conducted using confirmatory analysis to determine the dimensionality of the construct, nurse manager caring behavior. The null hypothesis was an eight-factor solution fitting the theoretical model being tested. The null hypothesis was rejected because none of the measures examined for goodness of fit indicated the model fit the data. Confirmatory factor analysis did not support the hypothesized structure; however, exploratory factor analysis supported a one-factor solution that was conceptually labeled caring behaviors. To decrease subject burden, the 94-item survey was reduced to 25 items using item reduction analysis including assessing minimum factor loadings of ≥0.60 and evaluating survey item-total correlation and alpha. The Cronbach's alpha of the new 25-item survey was 0.98. Conclusion The new 25-item Caring Assessment Tool-Administration survey provides hospital administrators, nurse managers, and researchers with a sound, less burdensome instrument to collect valuable information about nurse manager caring behaviors.