Development of a behavioral observation instrument to identify orientation of the Nurse toward parents of hospitalized children




Smith, Andrea

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A methodological study using descriptive, correlational, and comparative methods of research was conducted to develop, and establish initial validity and reliability of, the Orientation Behavioral Observation Instrument (OBOI). The observational instrument was developed as an initial step in the process of operationalizing and measuring Kurczynski's (1977) concept of "orientation". Scores on the OBOI place the nurse's behavior on a continuum of excluding, middle of the road, or including orientation toward parents of hospitalized children. A series of twelve videotaped vignettes of simulated nurse/parent-child interactions was developed to standardize data collection. Pediatric nursing experts evaluated the observation instrument and vignette scripts using two researcher designed evaluation tools. High mean expert rater scores on the evaluation tools provided evidence of content validity for the OBOI and vignette scripts. The completed videotaped vignettes were rated by five pediatric nursing experts using the OBOI. The expert scores were used to establish criterion scores for each vignette to examine support for criterion referenced validity. Following interrater reliability training, 40 professional registered nurses who were enrolled in a graduate nursing program, viewed the series of vignettes and rated them using the OBOI. Following a two week period, the nurse subjects again received rater training and viewed and rated the tapes. Subject rater scores were analyzed for interrater agreement using the Tinsley and Weiss (1975) interrater agreement index P. Interrater reliability was analyzed using Finn's r and intrarater reliability (stability) was examined using Pearson's r for total instrument scores, and Spearman's r for behavioral category scores. The level of interrater accuracy was evaluated by comparing the subject rater scores with the pediatric expert scores and determining the percentage of correct scores. The research findings demonstrated that the OBOI established evidence for content validity, and moderate to high levels of interrater accuracy, agreement, and reliability in classifying the nurse's orientation toward parents of hospitalized children based on ratings of six categories of observed nurse behaviors in a series of simulated videotaped nurse/parent-child interactions. The orientation behaviors described in Kurczynski's (1977) situational role management theory have support for initial empirical measurement.



Hospitalized children, Nurse-parents interaction, Orientation Behavioral Observation Instrument (OBOI)