Turkish Adaptation of the Novice Nurse Practitioner Role Transition Scale and Examination of Psycholinguistic and Psychometric Properties

Abstract

Turkish Adaptation of the Novice Nurse Practitioner Role Transition Scale and Examination of Psycholinguistic and Psychometric Properties

Abstract

Purpose: To assess the psycholinguistic and psychometric properties of the Turkish version of the Novice Nurse Practitioner Role Transition (NNPRT) scale. Material and Methods: This research was conducted with a cross-sectional and methodological design with novice nurses at a university hospital (n=374). Data were collected through using a descriptive characteristics form and the NNPRT scale. Descriptive statistics, factor analysis, Cronbach’s alpha, split-half reliability, and item-total correlation analysis were used in the evaluation. Results: The item-based content validity index of the scale varied between .89 and 1.00, and the scale-based content validity index was .98. The exploratory and confirmatory factor analyses revealed that the Turkish version of the scale was consistent with a six-factor structure. The Cronbach alpha coefficient was .94, the Spearman-Brown coefficient was .808, Guttman’s split-half coefficient was .805, the correlation between the forms was .678, and the item-total correlation varied between .48 and .50. Conclusions: With this study that the Turkish version of the NNPRT scale can use as a valid and reliable measurement instrument to measure novice nurses’ perceived experience concerning their transition to the practitioner role.

Keywords

• instrument development
• nurse practitioner
• practitioner role
• role transition

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Ethical Statement

Permission to use the scales employed in the study was obtained from the researchers who developed the scales. Written approval was obtained from the Non-Interventional Research Ethics Committee of a university (date: November 09, 2020) and from the management of the hospital where the study was conducted. The purpose of the study was explained to the participants, and their written consent was obtained. The article adhered to research and publication ethics.

Thanks

We thank all our colleagues who participated in and supported this study, as well as the institutional managers for their contribution to the implementation of the study.

References

1. World Health Organization. State of the world’s nursing 2020: Investing in education, jobs and leadership report. Available from: https://apps.who.int/iris/bitstream/handle/10665/331677/9789240003279-eng.pdf. [Last accessed 2022 Dec 7].
2. Alameddine M, Baumann A, Onate K, Crea M, Arnaout NE, Deber R. Job Stickiness of young nurses in Ontario: Does the employer organization participation in the Nursing Graduate Guarantee initiative make a difference? Health Policy 2017;121:809-15.
3. Logina A, Traynor M. The relationship between effective transition models and the optimal management of patient care. Br J Nurs 2019;28:168-73.
4. Park H, Yu S. Effective policies for eliminating nursing workforce shortages: A systematic review. Health Policy Technol 2019;8:296-303.
5. Leung PPL, Wu CH, Kwong CK, Ching WK. Nursing shortage in the public healthcare system: An exploratory study of Hong Kong. Enterp Inf Syst 2020;14:913-31.
6. Baker OG. New graduate nurses' transition: Role of lack of experience and knowledge as challenging factors. Saudi J Health Sci 2020;9:214-20.
7. Haddad M, Moxham L, Broadbent M. Graduate nurse practice readiness: A conceptual understanding of an age old debate. Collegian 2017;24:391-6.
8. Numminen O, Leino-Kilpi H, Isoaho H, Meretoja R. Newly graduated nurses' competence and individual and organizational factors: A multivariate analysis. J Nurs Scholarsh 2015;47:446-57.

9. Hickerson K, Taylor A, Terhaar M. The preparation‐practice gap: An integrative literature review. J Contin Educ Nurs 2016;47:17-23.
10. Duchscher JE. Transition shock: The initial stage of role adaptation for newly graduated registered nurses. J Adv Nurs 2009;65:1103-13.
11. Phillips C, Kenny A, Esterman A, Smith C. A secondary data analysis examining the needs of graduate nurses in their transition to a new role. Nurse Educ Pract 2014;14:106-11.
12. Powers K, Herron EK, Pagel J. Nurse preceptor role in new graduate nurses' transition to practice. Dimens Crit Care Nurs 2019;38:131-6.
13. Meleis, Afaf I. Transitions theory: Middle range and situation specific theories in nursing research and practice. Springer publishing company, 2010.
14. Duchscher JB. A Process of Becoming: The Stages of New Nursing Graduate Professional Role Transition. The Journal of Continuing Education in Nursing. 2008;39(10):441-450.
15. Benner P. From novice to expert. Am J Nurs 1982;82:402-7.
16. Wong SWJ, Che WSW, Cheng MTC, et al. Challenges of fresh nursing graduates during their transition period. J Nurs Educ Pract 2018;8:30-7.
17. Kocaman G, İntepeler Ş, Şen H, Yürümezoğlu H, Özbıçakçı Ş. İşe yeni başlayan hemşirelerin uyumlarını kolaylaştırmak için hazırlanan bir rehber hemşire eğitim programı örneği [An example of a preceptor nursing education program for novice nurses]. Journal of Education and Research in Nursing 2012;9:28-34.
18. Kukkonen P, Leino-Kilpi H, Koskinen S, Salminen L, Strandell-Laine C. Nurse managers' perceptions of the competence of newly graduated nurses: A scoping review. J Nurs Manag. 2020;28(1):4-16.
19. Labrague LJ, De Los Santos JAA. Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study. J Nurs Manag. 2020;28(5):1070-1079.
20. Berşe S, Ağar A, Di Rgar E, Tosun B. Examination of Transition Shock and Colleague Violence Among Newly Graduated Nurses: A Cross-Sectional Study. J Nurs Manag. 2024;2024:5486048.
21. Dertli S., Aktura S. Transition Shock Experienced by New Nurses: An Example From Turkey. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi. 2024;12(2):538–555.
22. Cao T, Huang X, Wang L, et al. Effects of organisational justice, work engagement and nurses' perception of care quality on turnover intention among newly licensed registered nurses: A structural equation modelling approach. J Clin Nurs 2020;29:2626-37.
23. Unruh LY, Zhang NJ. Newly licensed registered nurse job turnover and turnover intent. J Nurses Prof Dev 2014;30:220-30.
24. Ulupinar S, Aydogan Y. New graduate nurses' satisfaction, adaptation and intention to leave in their first year: A descriptive study. J Nurs Manag 2021;29:1830-40.
25. Mirza N, Manankil-Rankin L, Prentice D, Hagerman LA, Draenos C. Practice readiness of new nursing graduates: A concept analysis. Nurse Educ Pract 2019;37:68-74.
26. Çamveren H, Arslan Yürümezoğlu H, Kocaman G. Why do young nurses leave their organization? A qualitative descriptive study. Int Nurs Rev 2020;67:519-28.
27. Barnes H, Faraz Covelli A, Rubright JD. Development of the novice nurse practitioner role transition scale: An exploratory factor analysis. J Am Assoc Nurse Pract 2021;34:79-88.
28. Kline R. Exploratory and confirmatory factor analysis. In: Petscher Y, Schatschneider, Compton DL, editors. Applied quantitative analysis in the social sciences. 1st ed. New York: Routledge; 2013. pp. 169-207.
29. Dhamani K, Richter MS. Translation of research instruments: research processes, pitfalls and challenges. Africa Journal of Nursing and Midwifery. 2011;13(1):3-13.
30. Davis LL. Instrument review: Getting the most from a panel of experts. Appl Nurs Res 1992;5:194-7.
31. Borsa JC, Damaìsio BF, Bandeira DR. Cross-cultural adaptation and validation of psychological instruments: Some considerations. Paidéia (Ribeirão Preto) 2012;22:423-32.
32. Çam MO, Baysan Arabacı L. Tutum ölçeği hazırlamada nitel ve nicel adımlar [Qualitative and quantitative steps on attitude scale construction]. Hemşirelikte Araştırma Geliştirme Dergisi 2010;12:59-71.
33. ITC guidelines for translating and adapting tests. Int J Test 2018;18:101–134. Available from: https://www.intestcom.org/files/guideline_test_adaptation_2ed.pdf. [Last accessed 2022 Dec 7].
34. Machado R, Fernandes A, Oliveira A, Soares LS, Gouveia M, Silva G. Métodos de adaptação transcultural de instrumentos na área da enfermagem [Cross-cultural adaptation methods of instruments in the nursing area]. Revista Gaucha de Enfermagem 2018;39:e20170164.
35. DeVellis RF. Ölçek geliştirme – kuram ve uygulamalar [Scale development: Theory and applications] (T., Totan, Trans). Nobel Yayıncılık; 2017 (Original work published 2012).
36. Şencan H. Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlilik [Reliability and validity in social and behavioral measurement]. Seçkin Yayınevi, 2005.
37. Acar GM, Özer ÖY. Item removal strategies conducted in exploratory factor analysis: a comparative study. Int J Assess Tools Educ. 2022;9(1):165–80.
38. Brooks GP, Pokoo JS, Adjanin N, Johanson GA. Cross-loadings in scale development: Monte Carlo study of structural item-total correlation analysis with small samples. Gen Linear Model J. 2023;47(2):1-25.
39. Francisco-Pérez J, López-Guerra V, Ortíz G, et al. Psychometric properties and factorial structure of the Spanish version of the HLS-EU-Q16 questionary in Venezuelan adults. PLOS ONE. 2025;20(6):e0324782.
40. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007;30:459-67.
41. Ma W, He Y, Zhao W, Xu R, Liang T. Developing and validating the transition status scale for newly graduated nurses in China. J Nurs Manag 2021;29:1819-29.
42. Çiriş Yildiz C, Ergün Y. Development and psychometric testing of the Reality Shock Scale for newly graduated nurses. J Adv Nurs 2021;77:4950-62.
43. Haynes SN, Richard DCS, Kubany ES. Content validity in psychological assessment: A functional approach to concepts and methods. Psychol Assess 1995;7:238-47.
44. Sireci SG. Gathering and analyzing content validity data. Educ Assess 1998;5:299-321.
45. Büyüköztürk Ş. Sosyal bilimler için veri analizi el kitabı [Data analysis manual for social sciences]. Ankara: Pegem Akademi; 2020.
46. Özdamar K. Ölçek ve test geliştirme-yapısal eşitlik modellemesi [Scale and test development-structural equation modeling]. Nisan Kitabevi; 2017.
47. Seçer İ. Psikolojik test geliştirme ve uyarlama süreci: SPSS ve LISREL uygulamaları [Psychological test development and adaptation process: SPSS and LISREL applications]. Arı Yayıncılık; 2015.
48. Barnes H. Nurse practitioner role transition: A concept analysis. Nurs Forum 2015;50: 137-146.
49. MacLellan L, Levett-Jones T, Higgins I. Nurse practitioner role transition: a concept analysis. J Am Assoc Nurse Pract, 2015;27:389-97.
50. Cruchinho P, López-Franco MD, Capelas ML, et al. Translation, cross-cultural adaptation, and validation of measurement instruments: A practical guideline for novice researchers. J Multidiscip Healthc. 2024;17:2701-2728.
51. Seki EA, Özlük B. Workload and intention to leave among nurses in Turkey: The mediating roles of organizational identification and work satisfaction. Int Nurs Rev. 2025;72:1-10.
52. Çetinkaya Uslusoy E, Paslı Gürdogan E, Aydınlı A. Professional values of Turkish nurses: A descriptive study. Nurs Ethics. 2017;24(4):493-501.
53. Dertli S, Çevik Aktura S. Transition shock experienced by new nurses: An example from Turkey. Inonu Univ J Health Serv Vocat Sch. 2024;12(2):538-555.
54. Yıldız E, Seren Intepeler S. The effect of a structured orientation program on teamwork attitudes and nurse outcomes among novice nurses. BMC Nurs. 2026;25(1):1-12.
55. Öztürk H, Kurt Ş, Serin GM, et al. Problems experienced by nurses who just started working at hospitals. Acibadem Univ Saglik Bilim Derg. 2016;(4):189-201.
56. Erkorkmaz Ü, Etikan İ, Demir O, Özdamar K, Sanisoğlu SY. Doğrulayıcı faktör analizi ve uyum indeksleri [Confirmatory factor analysis and fit indices: Review]. Turk Klin J Med 2013;33:210-23.
57. Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res Online 2003;8:23-74.
58. Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research. 2006;99(6):323-338.
59. Marsh HW, Hau KT, Wen Z. In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Struct Equ Modeling. 2004;11(3):320-341.
60. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1-55.
61. Griffin‐Sobel JP. Research in practice: Evaluating an instrument for research. Gastroenterol Nurs 2003;26:135-6.
62. Clark LA, Watson D. Constructing validity: Basic issues in objective scale development. Psychol Assess 1995;7:309-19.