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ORIGINAL ARTICLE
Development and testing of an instrument to assess nurses’ knowledge,
risk perception, health beliefs and behaviours related to influenza
vaccination
Jing Zhang, Alison E While and Ian J Norman
Aims and objectives. To develop an instrument to measure nurses’ knowledge, risk perception and health beliefs towards influenza
and influenza vaccination and their vaccination behaviours and evaluate its construct validity and internal consistency reliability.
Background. Although instruments to assess predictors of nurses’ vaccination behaviours have been developed, their validity and
reliability have not been reported.
Design. Instrument development and initial validity and reliability testing.
Methods. The instrument was developed drawing on a literature review and expert consultation and was refined through pilot
work. A cross-sectional survey using a revised version of the instrument was conducted among a convenience sample of 520
registered nurses (response rate 77Æ4%). Cronbach’s alpha coefficient was calculated to determine internal consistency of the sub-
scale in the instrument. Principal components analysis with varimax rotation was carried out to evaluate the instrument’s construct
validity and examine its internal structure.
Results. Cronbach’s alpha coefficients for the three newly developed scales ranged from 0Æ70–0Æ76. Principal components analysis
produced a good fit and confirmed the internal design of the instrument. In the seasonal influenza knowledge sub-scale four factors
explained 44Æ8% of the total variance; in the H1N1 knowledge sub-scale two factors explained 44Æ7% of the total variance. Three
factors in the risk perception scale contributed 50Æ5% of the total variance and two factors in the vaccination behaviours scale
contributed 62Æ1% of the total variance.
Conclusions. An instrument has been developed to assess nurses’ knowledge, risk perception and health beliefs towards influenza
and influenza vaccination and their
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