Measuring honesty in nursing: scale development and validation

BMC Nurs. 2025 May 14;24(1):532. doi: 10.1186/s12912-025-03163-0.

ABSTRACT

BACKGROUND: Honesty is considered a desirable trait that can impact happiness and job performance. The clinical environment can present ethical challenges for nurses. A lack of honesty can lead to significant issues for both nurses and patients. Existing tools for measuring honesty have limitations and do not focus specifically on nurses. This study aimed to design and psychometrically evaluate a scale to measure honesty among nurses.

METHODS: This methodological study involved the design and validation of an honesty measurement tool for nurses. The study employed an inductive-deductive approach to generate items. The face (10 nurses), content (10 nursing experts), and construct validity (320 hospital nurses) of the scale were assessed, along with reliability using internal consistency and stability methods. The Item Impact Method was used for quantitative face validity determination. Content validity was assessed using qualitative and quantitative methods, with the participation of researchers and nursing experts. Cronbach’s alpha was used to assess internal consistency, and the test-retest method and Intraclass Correlation Coefficient (ICC) were used to assess reliability. Exploratory factor analysis (EFA) was used to assess construct validity.

RESULTS: The study resulted in an 8-item tool with two dimensions: behavioral honesty and verbal honesty. The tool explained 51.034% of the total variance. Cronbach’s alpha for the entire scale was 0.823, and McDonald’s omega was 0.898. The Intraclass Correlation Coefficient (ICC) was reported as 0.918, with a 95% confidence interval of 0.827 to 0.961.

CONCLUSION: The developed tool is a reliable and valid instrument for measuring honesty among nurses. This study contributes to the field by providing a tool to measure honesty in nurses. The tool’s scoring system effectively distinguishes between different levels of honesty in nursing practice, with elevated scores reflecting greater adherence to honest professional conduct. This tool can be used by managers and organizational decision-makers to enhance the quality of management planning.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40369564 | DOI:10.1186/s12912-025-03163-0