Page 313 - Encyclopedia of Nursing Research

280 n MEASUREMENT AND SCALES

under study. Volume, length, and weight are clinical settings of nurse researchers. Often
commonly measured by ratio scales. the instruments developed in other fields
M There is controversy about the level of were not sensitive to clinically relevant attri-
measurement scales and the type of statis- butes of concern to nurses in populations
tical procedures that may be appropriately such as children, frail patients, the elderly,
used for data analysis. There are researchers and the culturally diverse.
and statisticians who believe that only non- The movement in nursing to develop more
parametric statistical procedures can be used rigor in the use and development of measure-
for data analysis when data are nominal or ment instruments gained prominence in the
ordinal and that inferential statistics can be 1970s. In June 1974, a contract was awarded
properly applied only with interval and ratio to the Western Interstate Commission for
data. There is controversy about whether Higher Education by the Division of Nursing,
Likert scaling (which is often used in nurs- Bureau of Health Manpower, and Health
ing with measures of attitude or opinion) is Resources Administration to prepare a com-
in actuality ordinal-level measurement for pilation of nursing research instruments and
which only nonparametric statistics should other measuring devices for publication.
be used. Likert scaling involves having sub- With Doris Bloch as project officer, a two-
jects rank their responses to a set of items on volume compilation of instruments, titled
a range of numbers, such as “1” to represent Instruments for Measuring Nursing Practice and
lack of agreement to “5” to represent complete Other Health Care Variables, was published in
agreement. It has been the accepted practice 1978 (Ward & Lindeman, 1978). Priority was
for investigators to use scores generated with placed on compiling instruments dealing
Likert-type scales as interval-level data. with nursing practice and with patient vari-
Nurses have typically borrowed many ables rather than nurse variables. This was
measures from other disciplines. This reflects an important milestone for nursing mea-
the fact that nursing is a field that considers surement because it was the first effort that
the biological and psychosocial aspects of placed a large number of clinically focused
care and is based on knowledge generated instruments developed or used by nurses in
by many fields of inquiry. Therefore, many the public domain.
measures developed by other disciplines are During the late 1970s and early 1980s,
consistent with nurses’ measurement needs. nurse scientists began to focus their work on
However, the heavy dependence on borrow- developing measurement as an area of spe-
ing measures from other disciplines reflects cial emphasis in nursing. At the University of
the trend in the 1970s for nurses to pursue Arizona–Tucson, Ada Sue Hinshaw and Jan
doctoral education in related fields, such as Atwood focused their efforts on refining and
education, psychology, sociology, and phys- further developing instruments for clinical
iology. Nurses became familiar with mea- settings and for clinically focused research.
sures from other fields during their graduate The first postdoctoral program in nursing
studies and were encouraged to use them in instrumentation and measurement evolved
the nursing context. at the University of Arizona, and annual
By the mid-1970s, nurses became more national conferences on nursing measurement
cognizant of some of the limitations in bor- were offered. Ora Strickland and Caroyln
rowing certain measures and instruments Waltz at the University of Maryland at
from other disciplines. For example, it is not Baltimore focused on defining measurement
unusual for instruments developed to mea- principles and practices to build rigor in nurs-
sure psychosocial variables in other fields to ing research. Careful assessments of nursing
be cumbersome and inefficient for use in the research published in professional journals