Translation, Cultural Adaptation and Psychometric Evaluation of the Transformational Leadership Scale in Intensive Care Unit Nurses: Empirical Research Quantitative.

backgroundTransformational leadership, based on inspiration, motivation and trust-building within teams, is considered one of the most effective management styles in healthcare. In nursing, transformational leadership promotes open communication, interdisciplinary collaboration and the implementation of preventive measures, which directly impact the quality of care and reduce medical errors. AIM(S): The aim of this study was to apply the Transformational Leadership Scale to the Polish cultural context and to evaluate its psychometric properties among intensive care nurses.

methodsA cross-sectional, descriptive study was conducted to perform the cultural adaptation and psychometric validation of the Transformational Leadership Scale. The study included 433 nurses working in adult intensive care units in Poland, recruited via convenience sampling. Data were collected between March and November 2022. The survey consisted of three parts: (1) general information, (2) the Transformational Leadership Scale and (3) socio-demographic data. The questionnaire comprised 54 items, divided into two main sections concerning: (1) the immediate supervisor (43 items) and (2) the Director of Nursing (9 items). Responses were recorded using a 5-point Likert scale. The questionnaire was translated using a forward-backward translation procedure with a monolingual test. Content validity was assessed by experts using the item-level (I-CVI) and scale-level (S-CVI) content validity indices. Confirmatory factor analysis (CFA) was performed to assess model fit. Reliability was assessed using McDonald's ω, Cronbach's α and composite reliability (CR), while convergent validity was examined using the average variance extracted (AVE).

resultsItems in the I-CVI ranged from 0.75 to 1, and the mean score for the S-CVI was 0.944. CFA confirmed that the five-factor model with 54 items demonstrated a good fit to the data. The analysis confirmed the high reliability of the subscales (McDonald's ω = 0.935 to 0.971, Cronbach's α = 0.934 to 0.971, CR = 0.924 to 0.980) and convergent validity (AVE = 0.639 to 0.799).

conclusionThe Transformational Leadership Scale is a valid, reliable and culturally adapted instrument for measuring transformational leadership among Polish intensive care nurses. IMPLICATIONS FOR THE PROFESSION: The application of the Transformational Leadership Scale may be valuable for designing and implementing appropriate management strategies to support the development of a transformational leadership style in nursing. IMPACT (ADDRESSING): What problem did the study address? There is no psychometrically correct tool for assessing Transformational Leadership in Poland. What were the main findings? The Transformational Leadership Scale is a psychometrically valid tool for critical care nursing. Where and on whom will the research have an impact? The results provide a psychometrically correct tool for the assessment of transformational leadership in the environment of critical care nurses in Poland and will complement the knowledge in the country and abroad in the area of transformational leadership. REPORTING

methodThe manuscript's authors have adhered to the EQUATOR guidelines, using the STROBE reporting guidelines. NO PATIENT OR PUBLIC CONTRIBUTION: Patients or members of the public were not involved in this study.