Validation and Application of the Chinese Integral Nursing Leadership Scale Among Clinical Nurses

BACKGROUND: The leadership of nurse managers critically influences the development of nursing teams and advancement of healthcare institutions. However, no validated instrument exists to assess integral leadership among Chinese nurse managers. Recently, the Integral Nursing Leadership Scale (INLS) has been developed and applied. AIM: To translate the INLS into Chinese, validate the psychometric properties of the Chinese version (CV-INLS), and explore clinical nurses' evaluations of integral nursing leadership among nurse managers. METHODS: The INLS was translated into Chinese according to Brislin guidelines. A convenience sample of 662 nurses completed the 30-item CV-INLS. The psychometric properties of CV-INLS, including structural validity and reliability, were evaluated following COSMIN guidelines. The validated CV-INLS was subsequently used to assess clinical nurses' perceptions of integral nursing leadership among Chinese nurse managers (n = 1, 023). RESULTS: The content validity (I-CVI = 0.929-1.000, S-CVI/AVE = 0.993) of the CV-INLS was satisfactory. Structural validity supported the four-factor model with an acceptable model fit in the confirmatory factor analysis (CFI = 0.973, TLI = 0.970, RMSEA = 0.069, SRMR = 0.050). Multigroup CFA supported measurement invariance across age and education groups (configural, metric, and scalar/threshold invariance). Construct validity was supported by evidence of convergent and discriminant validity. In addition, excellent reliability was shown with an ordinal α of 0.942, ω of 0.943, and an ICC of 0.987. In the validation sample, the clinical nurses' evaluations of nursing managers indicated moderately high leadership levels, with an overall CV-INLS total score of 118.04 ± 29.69. Perceived integral nursing leadership levels were associated with age (30-39 years), educational level (bachelor's degree or higher), years of experience (10 years or more), and working in an ICU setting. CONCLUSIONS: The CV-INLS showed strong psychometric properties and can be used to assess perceived integral nursing leadership among nurse managers. Perceived integral nursing leadership was moderately high among nurses in the surveyed tertiary hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: The CV-INLS may provide useful insights into perceived integral nursing leadership among nurse managers and inform leadership development in tertiary hospital settings.