Development and validation of an instrument to measure nurses' beliefs toward deaf and hard of hearing interaction

Communication barriers experienced by Deaf signers, non-signing deaf, and hard of hearing (DdHH) individuals in healthcare environments are multidimensional and complex. Investigating what nurses believe about DdHH patient interaction is an important step in minimizing barriers and improving nursing care. This research addressed the lack of reliable instruments to assess nurses’ beliefs toward DdHH interaction through instrument development guided by King’s (1981) Theory of Goal Attainment and Transactional Communication Model. A quantitative methodological design was used to develop and test the validity and reliability of an instrument to measure registered nurses’ beliefs toward interaction with DdHH patients and certified interpreters (CIs). An initial pool of items to assess registered nurses’ beliefs toward DdHH interaction was developed based on an extensive review of literature. Item pool content was validated by six content experts including one Deaf signer, one Deaf nurse, two hard of hearing nurses, and two hearing CIs. The initial D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) included 58 items. The first wave of data collection and analyses resulted in a 25-item DdHH-IBS/RN consisting of two factors: Personal-Social Beliefs Domain and Interpersonal Beliefs Domain. The 25-item DdHH-IBS/RN was subjected to a second wave of data collection and analysis to further refine and validate the instrument. Psychometric analysis of two separate groups of data concluded that the newly developed DdHH-IBS/RN is a reliable and valid scale to measure nurses’ beliefs towards DdHH interaction. Results of confirmatory factor analysis (CFA) supported the hypothesized structure of the scale and provided some evidence for its factorial validity. Results of correlation analyses revealed a weak positive correlation between years of experience interacting with non-signing deaf and hard of hearing individuals and Personal-Social mean scores. Regression results indicated that the overall model moderately predicted Personal-Social subscale mean scores and had no significance in predicting Interpersonal subscale mean scores. Independent samples t tests showed significant differences between participants with and participants without prior education and experience specific to DdHH interaction on both Personal-Social and Interpersonal subscale mean scores. Further improvement of scale items, and retesting for validity and reliability is recommended.