Page 314 - Encyclopedia of Nursing Research

MEASUREMENT AND SCALES n 281

revealed that nurse investigators were not on the specification of nursing interventions
giving adequate attention to reliability and to address the identified nursing diagnoses.
validity issues when selecting and develop- The NOC Study was particularly important M
ing instruments. Nurse investigators tended for the advancement of nursing measure-
to rely too heavily on paper-and-pencil self- ment because it took on the challenge of
report measures and did not give adequate developing measures that could empirically
attention to selecting biological measures as document outcomes of nursing care.
indicated by the conceptual frameworks of The nursing profession has developed
the studies (Strickland & Waltz, 1986). The nursing measurement to a great degree over
Maryland group published the first mea- the past four decades. Nurses have developed
surement textbook for nurses, Measurement in and tested instruments for use in a variety
Nursing Research (Waltz, Strickland, & Lenz of settings, created many new instruments,
1984), and implemented a measurement pro- and further developed measures designed in
ject funded by the Division of Nursing of the other disciplines for use in nursing. Although
Department of Health and Human Services. greater focus has been placed on assessing and
This project prepared more than 200 nurse reporting reliability, precision, accuracy, and
researchers to develop and test instruments validity of measures in clinical settings and
for use in nursing and resulted in the initi- nursing research, inadequate attention has
ation of a series of books, Measurement of focused on the metric qualities of laboratory
Nursing Outcomes, which compiled instru- physiological measures and on quality control
ments developed for the nursing context. procedures for the enhancement of clinical
In 1993, Ora Strickland initiated and measurements. There is still inadequate atten-
edited the Journal of Nursing Measurement tion given to “the specification of the concep-
with Ada Sue Hinshaw as coeditor. This tual base of measurement tools, and, a heavy
journal brought nursing measurement to a reliance on the use of self-report data, attitu-
new level of focus, responding to the need dinal and perceptual measures, and the use of
for continuing development and dissemina- questionnaires and rating scales” (Strickland,
tion of nursing measurement instruments DiIorio, Coverson, & Nelson, 2007). Measures
and providing an identifiable forum for the frequently have not been validated for or are
presentation and discussion of measurement not available for minority and low socioeco-
concerns in nursing. nomic populations, children, frail patients,
As nursing moved into the twenty-first and those with limited verbal communica-
century, the development of nursing mea- tion. Long and cumbersome instruments that
sures continued to evolve with a focus on are difficult for clinical populations to under-
documenting patient care outcomes through stand and complete validity remain an issue.
empirical assessment with well-designed The increasing number of immigrants in the
clinically validated outcome measures. general population has brought the need to
Under the leadership of Meridean Maas at validly translate and use existing instruments
the University of Iowa, the National Institute with a diverse population to the forefront
of Nursing Research funded the Nursing as nursing measurement issue. Nursing stud-
Outcome Classification (NOC) Study. NOC ies of families, communities, and organiza-
was implemented as a natural outgrowth tions and systems have been hampered by the
of the North American Nursing Diagnoses lack of effective measures to address group
Association’s movement, which emphasized and system variables from the nursing per-
the careful classification and documenta- spective (Strickland, 1995).
tion of nursing diagnoses, and the Nursing
Intervention Classification, which focused Ora Lea Strickland