Development and validation of scales measuring individual, nursing unit, hospital, and community factors related to fertility intentions of female Japanese hospital nurses.

Background: Scales that comprehensively measure individual, workplace, and community factors related to fertility intentions of women are limited. This study examined the psychometric properties of scales measuring individual (nurse, husband/partner, and child), nursing unit, hospital, and community factors related to fertility intentions of female Japanese hospital nurses. We focused on these nurses because nursing is a gendered profession, and over 90% of nurses in Japan are women. Furthermore, Japanese hospital nurses differ from other female workers in several ways (e.g., professionality, working shifts, financial remuneration).

Methods: This was a methodological study. Data were collected using a cross-sectional, self-administered questionnaire survey. Data from 898 Japanese female hospital nurses (age range, 20-49 years) from 50 hospitals were analyzed. The initial scales were developed through semi-structured interviews, a literature review, an expert review, and a pilot study. Item analysis and exploratory and confirmatory factor analyses were performed, Cronbach's α was calculated, and known group validity was examined.

Results: The following individual factor scales were obtained: a 12-item, four-domain nurse factor (Economic Needs, Timing of Life Events, Nursing Aspirations, and Career Development) scale, a six-item, two-domain husband/partner factor (Share of Housework and Childcare and Relationship with Husband/Partner) scale, and a three-item, one-domain child factor scale. Likewise, we identified a 13-item, four-domain nursing unit factor (Guilty Feelings toward Colleagues, Unit Nurse Manager's Management, Workability, and Collegiality) scale, a nine-item, three-domain hospital factor (Access to Legal Rights, Support for Mothers, and Comfort in Hospitals) scale, and a six-item, two-domain community factor (Governmental Family Support and Culture of Working Women) scale. Except for the child factor scale, the comparative fit index was > 0.950, and the root mean square error of approximation was < 0.070. Cronbach's α ranged from 0.590 (community factor scale) to 0.807 (child factor scale). The scores on the nurse, husband/partner, and hospital factor scales were significantly higher for nurses with high than with low fertility intentions.

Conclusions: These results support the reliability and validity of the nurse, husband/partner, and hospital factor scales. The child, nursing unit, and community factor scales can be further improved.