ArticleNursing ethics2022
Ethical decision-making confidence scale for nurse leaders: Psychometric evaluation.
Article in Nursing ethics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Developing Clinical Leadership in Orthopedic Nursing: A Qualitative Study to Identify the Components of a Complex Intervention.Healthcare (Basel, Switzerland) · 2026Article
- Moral Courage and Ethical Decision-Making Among Registered Psychiatric Nurses in Western Canada: A Cross-Sectional Multiple-Methods Study.International journal of mental health nursing · 2026Article
- Ethical decision-making confidence among nurse leaders: a mixed-methods study of determinants and ethical implications.Frontiers in medicine · 2026Article
- Translation, Cultural Adaptation and Preliminary Psychometric Testing of the Managerial Ethical Profile Scale for Finnish Health and Social Care Sector.Scandinavian journal of caring sciences · 2025Article
- Characterizing the Decision-Making Competency of Nurse Managers: A Scoping Review.Journal of nursing management · 2025Article
- Strategies and challenges in addressing ethical issues in the hospital context: A phenomenological study of nurse team leaders.Belitung nursing journal · 2023Article
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Authors and funding
4 authors.
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Abstract
backgroundEthical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework.
aimsThe objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale.
methodsThe cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were used to develop the scale.
participantsA convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position. ETHICAL CONSIDERATIONS: Ethical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent.
resultsThe scale's item structure dimensionality and subscale's reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe. DISCUSSION: This exploratory study is the first of its kind to focus on nurse leaders' confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales' psychometric properties.
conclusionThis newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups.
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