339

Learning Objective #1: understand issues related to one major aspect of nurses' patient advocacy role -- safeguarding patients' autonomy.

Learning Objective #2: learn the process of developing a valid and reliable scale.

---

Safeguarding patients’ autonomy, as one major aspect of nurses’ patient advocacy role, is becoming more important for patients and the nursing profession. The dominant values in the United States such as individualism, liberty, human rights, and autonomy encourage a patient’s right to have more input and control over his or her health care. However, patients’ capacity to exercise their rights is often impaired due to illness and limited knowledge about medicine, nursing, and the health care system. Aggressive and swift use of treatment technologies in the hospital tend to ignore patients’ quality of life and right to self-determination. Thus patients need advocates to safeguard their rights to make health care decisions. Among all the health care providers, nurses are best positioned to protect their rights to self-determination. The purpose of this study was to develop and test attitude toward safeguarding patients’ autonomy scale (ASPAS). Fishbein and Ajzen’s definition of attitude and Bu and Jezewski’s definition of safeguarding patients’ autonomy guided the development of the scale. A panel of seven experts evaluated content validity of the scale. Content Validity Index (CVI) was 83%, calculated based on the experts’ agreements. The ASPAS was revised based on the experts’ comments. Two mail survey studies were conducted to test psychometric properties of the ASPAS. In Study 1, test-retest reliability was .94, calculated using Pearson correlation coefficients of scores from the two administrations of the scale (n = 27). Cronbach’s alpha was .95 among the initially returned 60 questionnaires. In Study 2, exploratory factor analysis was conducted using 472 returned questionnaires to extract factors and determine the items to be included in the scale. Cronbach’s alpha was .88 among the 472 questionnaires. Results indicated that the ASPAS possessed satisfactory psychometric properties and was appropriate to assess nurses’ attitudes toward safeguarding patients’ autonomy.