Reliability and validity testing of the Adolescent Transaction Scale




Brown, Mary Heiens

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The purpose of the study was to psychometrically test a newly developed instrument, the Adolescent Transaction Scale (ATS), to measure adolescent's assessments of transactions with health care providers (HCP). The ATS was based on Imogene King's theory of goal attainment and her operational definition of transaction, one of the concepts of her theory.

Reliability and validity were established by calculating a Cronbach's alpha and doing a factor analysis using principal axis factoring with orthogonal varimax rotation. Content validity had been previously established. A convenience sample of 250 students 15–17 years of age who were in tenth grade homeroom classes at a large suburban public high school completed usable surveys. Participation was voluntary and implied parental permission with adolescent consent was used.

A Cronbach's alpha correlation coefficient was used to estimate internal validity. Cronbach's alpha on the 32-item scale was 0.8210. Inter-item correlations were reviewed and used to further revise the instrument. Following revisions based on the inter-item correlations and factor analysis, the alpha of the final 16-item scale was 0.9226.

The final factor analysis procedure produced three factors with 16 items that loaded at 0.45 or higher. Rotation converged after eight iterations and accounted for 51.9% of the variance. Five of King's six elements in her operational definition of transaction loaded into three factors. Initiate and respond on one factor, means explored and agreement on means with movement toward the goal on one factor, and problem identified on one factor. The sixth element, goals set, was not represented by any one factor, but loaded on factors one and two.

The final 16-item scale possesses excellent internal consistency reliability and construct validity. These 16 items will serve as a strong core for further development of the ATS.



Health and environmental sciences, Psychology, Adolescent Transaction Scale, Nurse-adolescent interaction, Scale development