Development and Psychometric Evaluation of the Behavioral Risk Assessment Scale for Work-Related Musculoskeletal Risk in Nurses (BRASM-N).

Abstract

Work-related musculoskeletal disorders among nurses arise from a complex interaction of physical, organizational, and psychosocial factors. Existing assessment tools often focus on isolated risk domains, limiting their applicability in comprehensive ergonomic risk evaluation. This study aimed to develop and evaluate the psychometric properties of the Behavioral Risk Assessment Scale for Work-Related Musculoskeletal Risk in Nurses (BRASM-N). Instrument development followed a multistage process including item generation, expert content validation, pilot testing, and field testing. The scale was administered to 382 hospital nurses, with exploratory and confirmatory factor analyses conducted on independent subsamples. Reliability was examined using internal consistency and test-retest methods, and construct validity was assessed through convergent and discriminant validity. Content validation produced a 22-item scale with acceptable to excellent item relevance (I-CVI = 0.78-1.0). In 382 nurses, exploratory and confirmatory factor analyses supported a stable four-factor structure with good model fit (CFI = 0.94, TLI = 0.93, RMSEA = 0.049). Internal consistency was acceptable to excellent across subscales (Cronbach's α = 0.72-0.85; total α = 0.90). Test-retest reliability was strong (ICC = 0.76-0.91). Floor and ceiling effects were minimal. Convergent and discriminant validity were supported through correlations with work ability, job control, stress, and coping measures. The BRASM-N is a psychometrically robust, multidimensional instrument for assessing behavioral risk factors associated with work-related musculoskeletal risk in nurses and may support ergonomic screening and preventive interventions in occupational health settings.