Factors Affecting Nurses' Management of Infant Pain in Korea

Purpose: The purpose of this two-phase design study was to provide reliable and valid Korean-language versions of three instruments—Pain Knowledge and Use (PKU), Collaboration and Satisfaction About Care Decisions (CSACD), and Environmental Complexity Scale (ECS)—to be used to measure Korean nurses’ knowledge about infant pain management, nurse-physician collaboration, and work environment in NICUs. Phase 1 included committee translation, first round of expert panel review, cognitive interviews, translation committee review, and second round of expert panel review. Phase 2 included psychometric evaluation. Sample/Methods: Three translators and two senior reviewers translated and reviewed the 56 items of the three instruments into Korean. A panel of eight experts reviewed content relevance of the translated instruments to Korean NICU settings using a content validity index (CVI). Twelve Korean NICU nurses participated in cognitive interviews via Skype to assess their understanding of the instrument items. A translation committee reviewed the results of the first expert panel review and cognitive interviews; they approved a final version of each instrument. A panel of three experts evaluated content relevance of a final version of the instruments using a CVI. A total of 159 Korean NICU nurses completed the instruments to assess reliability and validity of the Korean versions. Results: In the first expert reviews, the item-CVI was less than .78 for 1 of 25 PKU items, 3 of 9 CSACD items, and 10 of 22 ECS items. In cognitive interviews, 1 PKU item and 3 ECS items were found to be unsuitable in the Korean setting; all CSACD items were acceptable. Based on the expert review and cognitive interview results, unsuitable items were modified or deleted. In the second expert review, the scale-CVI was 1.00 for all three instruments. In psychometric evaluation, Cronbach’s alphas were .88 for PKU-K, .94 for CSACD-K, and .92 for ECS-K. Confirmatory factor analysis showed an acceptable model fit for PKU-K and CSACD-K; the ECS-K model was a poor model fit. Conclusions: The study provides significant evidence of the reliability and validity of Korean versions of the PKU, CSACD, and ECS.