Nursing Quality Scale (NQS): Test Development

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Nursing Quality Scale Running Head: Nursing Quality Scale Nursing Quality Scale (NQS) Test Development Marife Mamauag Carlo Magno De La Salle – College of Saint Benilde 1

description

The study developed a scale that measures nursing characteristics. The scales proposed are caring, commitment, compassion, and communication. The items were calibrated usig an IRT Rasch model. The results confirmed the four scales and a final scale with 160 items.

Transcript of Nursing Quality Scale (NQS): Test Development

Page 1: Nursing Quality Scale (NQS): Test Development

Nursing Quality Scale

Running Head: Nursing Quality Scale

Nursing Quality Scale (NQS)

Test Development

Marife Mamauag

Carlo Magno

De La Salle – College of Saint Benilde

Nursing Quality Scale (NQS)Test Development

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Rationale

Measurement of health has been given greater importance over the years in the light of quality assurance because of increasing global changes in health care organizations. Assessing and evaluating effects of changes on organizational and individual well-being require more valid and reliable techniques.

More health professionals believe that they have a pretty good idea as to what makes for quality nursing care. Oftentimes they think that competence alone is enough. Recent international nursing standard however, stipulate that quality nursing care requires not only technical skills and critical thinking for sound decision-making but interpersonal skills as well.

Unlike in the past, the importance of a global view of work quality and health has now been strongly emphasized. There is a need for more refined and specific assessment tools to measure quality nursing care. Studies have shown strong evidence that aside from aptitude personal attributes have importance implications for nurse selection and training. (March, et al. 1996; Mrayyan, 2004; Bakalis, et al., 2005; Schreiber, 1999; Clark, et al., 1997; Fealy, 2004; Corliss, 1994; Boblin-Cummings, 1996; Kleiman, 2002).

According to the country’s standard of quality nursing care, there are four (4) C’s that make a good nurse, namely: Commitment, Caring, Compassion, and Competence. While Competence could be well measured by aptitude and achievement tests, measures for the other three Cs have yet to be defined, refined, and constructed.

Qualities of a Nurse

Several researches over time have shown evidence of the importance of personal attributes in quality nursing care. Commonly perceived attributes or characteristics by both nurse-experts/practitioners and patients are the following: Compassion, Caring, Commitment, and Connectedness.

To validate these findings in the local setting, a personal interview (face-to-face) was conducted in April 2005 among 35 nurses who have been practitioners for at least three years, randomly selected from the UP-GH, UST, and MDH. The top ten traits identified a good nurse should possess are the following: competence, dedication and commitment, compassion, T-L-C (tender-loving-care), patience,

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responsibility over others, trustworthiness, integrity, cheerfulness, and grace under pressure.

Compassion. Imogene King’s Interacting Systems model (1981) that supports the need for a baccalaureate degree as entry level for professional nursing, address the question: What are the characteristics of high quality nursing care? Within Fawcett’s (1997) structural hierarchy of contemporary nursing knowledge, the meaning of high quality nursing care is found in the metaparadigm relational proposition: nursing is concerned with the nursing actions in the person’s health status.

Quality is seen as an experiential judgment emerging from the nurse patient interaction (Gunther, 2001; Fedorawicz, 2002) as advocated in the King’s model. It requires the nurse’s understanding, self-awareness and perceptual accuracy to guide communication effectively during the nurse-patient interaction.

It is further assumed that nurses who are intuitive and empathic provide high quality nursing care (Reynolds, 1999). Dungan model of dynamic integration (DMDI) views humans as possessing synergistic dimensions of body, mind, and spirit. Therapeutic relationships are accomplished through the provision of presence, listening, and communication through “mutuality of concern” which is a construct believed synonymous with empathy.

Research findings of Brown (1990) indicated that nurse empathy positively influences patient satisfaction with care. Nurses and patients agreed that the relationship developed between the nurse and patient is very important. Patients identified the most important nursing action as “being there”, and “taking time to sit down and listen”

Using a 5-service quality index (tangibles, reliability, responsiveness, assurance, and empathy), Osuna (1998) further contended that there is no significant difference demonstrated in patient’s overall expectations of quality nursing care and patients’ overall perceptions of actual care receive.

A closely related construct to empathy is compassion. It means being aware of and sensitive to the feelings, need and well-being of others, demonstrating kindness and empathy toward others by taking action to make a difference where one can.

Identified by health professionals and consumers alike as the cornerstone of quality nursing care, compassion within the context of nursing education (Peters, 2003) means forming connections with

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others, walking a mile in their shoes, recognizing needs, burdens, and suffering, embracing the emotional response to suffering, acting to make it better, giving and receiving gifts, and being aware of the boundaries of the professional role.

Caring. Patient outcomes are key aspects of quality nursing care. Caring and providing comfort were considered most important outcome to patients, who oftentimes seek health care for relief of physical and psychosocial distress (Yen, 1994; Nandlal, 1995). Patient comfort and care are dimensions of preferred outcome, however, in nursing literature these have long been seen as difficult to define and measure.

Using grounded theory approach, Larsen (1998) attempted to identify components of quality nursing care in nursing homes. Findings show that residents, the qualities are: staff who care, personal care and safety, sociality/personal recognition, accommodation, personal choices and family.

Commitment. In the State University of West Georgia nursing student handbook, commitment has been defined as the affective ability needed to keep one’s obligations congruent with one’s trust, i.e., a nurse’s obligation to the profession of nursing. It includes attitudes of empowerment, advocacy, assertiveness, courage, self-responsibility and accountability, and a profound desire to “maintain and elevate the standards of the profession”. Collaborative attitudes include respect for diversity, a positive response to change, and belief in “power with” rather than “power over”.

Used as a goal for a standard, commitment occurs whenever goal acceptance increases; there is greater congruence between the assigned and personal goals (Meyer & Gellatly, 1988).

In an ethnographic study that examined the attributes of nurses that are important in caring from the relatives’ perspective, process (Ming Ho Loo & Mackenzie, 1996) are the nurses’ competence and commitment to the job, and it was shown that their relationships with the patient and the family were considered important. Quality has been judged not only by the patents, but also by the ways in which they work with the family.

Closely related construct to commitment is priority setting which has been considered as important skill in nursing. Recent studies, however, suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nursing education.

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Priority setting, according to Hendry & Walker (2004), means the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting include the nurse’s expertise, patient’s condition, availability of resources, ward organization, philosophies and models of care, nurse-patient relationship, and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted along this area.

Despite extensive interest in commitment, mainly in the psychological and organizational behavior literature, there has been little empirical research into the meaning of commitment in relationships, the processes that underlie commitment and how they affect the relationship outcome.

Connectedness. For the past decade, nurse-client contracting has been used with increased frequency by nurses in many health care settings. Generally, nurse-client contracting is a means of delivery effective nursing care (Sheridad, 1983).

From the perspective of patients, high quality nursing comprised of the following: competence, coaching, connection and immediacy (Budgen, 1988). The construct of nurse-patient bonding has been explored several times the early decades of the 20th century. Oftentimes, the concept of nurse empathy has been shown to be manifested within the context of bond variations (Ramos, 1990). There seems to exist an overlapping between the constructs of empathy and bonding.

Empathy as commonly described by the nurse-experts oftentimes bear a resemblance of the affective, cognitive, and instrumental types of processing described in most psychology literature. Certain critical incidents describing nurse-patient relationships seemed to exemplify the understood common meaning of empathy, particularly those seen with a specific type of relationship characterized by mutuality/reciprocity, resolved control issues, and prolonged or intense contact.

According to a study conducted by Yow (1992), nurse-patient interactions are important in the delivery of effective nursing care. The combined effects of role and personal relationships influence the working relationships that develop between nurses and patients. Categories of role relationships are direction and information

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exchange. The category that describes relationships, on the other hand, is rapport.

Moreover, nurses are expected to develop some of the features of what Morse (1991) described as a “connected care relationship”. Person-centered care relies on effective nurse-patient communication. The central tenet of person-centered care is that nurse practitioners work closely with the patients’ perspectives and needs (Clarke et al 2003). Through effective communication skills, nurses need to know how to “say the words” that give shared meaning and respect for dignity to physical care.

Conceptual Framework

Grounded on the aforementioned research finding as shown in the existing literature about nursing quality care, a conceptual framework was drawn up to serve as the blueprint in the construction of the Nursing Quality Scale of the NQS. The framework embodies the viewpoints commonly expressed by the both the patients and nurses on what quality nursing care is.

Figure 1. Five Cs – Nursing Quality Scale Framework

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Viewpoints

Nurse- Experts’/Practitioners’

Quality Nursing Care

Commitment Compassion Caring Connectedness Competence

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Method

Purpose to be Served by the Test

The NQS is part of a battery of tests called Assessment for Nursing Potential (ANP) designed to select and place nursing students to the upper level of college education. The ANP consists of three (3) tests, namely: aptitude test, measuring the “innate-based” learned abilities (verbal reasoning, quantitative reasoning, abstract reasoning); achievement test, measuring the learned abilities in the first two years in nursing (psychology, communication skills, algebra, basic physical sciences, basic life sciences); and the nursing attitudinal inventory, or the NQS which assesses the traits that are essential for a nursing student to contribute to one’s success in the nursing profession. The NQS, therefore, addresses the affective measurement in the ANP.

Considered a strong base for selecting students to the upper nursing level, the ANP serves as a good preparation for the nursing board exam and other foreign-based tests like the NCLEX or CGFNS.

Scale Content and Specifications

The Nursing Quality Scale (NQS) measures an individual’s likelihood of possessing a wide array of personal traits that are desirable for quality nursing care. It consists of four (4) sub-scales, namely: Compassion, Commitment, Caring, and Connectedness, with a total of 150 items each in an agreement scale of 1 (strongly disagree) to 4 (strongly agree). There are two forms of tests constructed (See appendix B and C).

The operational definitions of these sub-scales and are shown in the Table of Specifications.

Table 1

NQS Table of Specifications

Area Scale Definition No.ofItems

Compassion Being aware of and sensitive to the feelings, 76

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Patients’/Clients’

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needs, and well-being of others, demonstrating kindness and empathy toward others by taking action to make a difference, and ability to work with others for a common goal. This includes attitudes such as respect for diversity, positive response to change, and belief in “power with” rather than “power over”.

Commitment Affective ability needed to keep one’s obligations congruent with one’s desires and to guide choices related to one’s trust, that is, a nurse’s obligation to the profession of nursing (Meyer & Gellalty, 1988; Meyer & Allen, 1991). It includes attributes of empowerment, advocacy, assertiveness, courage, self-responsibility and accountability, and profound desire to maintain and elevate the standards of the profession.

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Caring Basic way of being, the essence of nursing and means that people, interpersonal concerns and things matter (Watson, 1979). Caring for self and others involves self-awareness and belief in personal empowerment, maintaining academic and practice standards to ensure the quality of the profession.

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Connected-ness Fundamental human motivation (Baumeister and Leary, 1995); positive interactions within an ongoing relational connection (Townsend & McWirter, 2005); an increased sense of well-being that comes from feeling connected to others, motivation and the ability to act positively both within and beyond the boundaries of the relationship, increased self-knowledge of the “other” in the relationship, an increased sense of self-worth, and the desire for additional connections (as cited in Riggs & Bright, 1997).

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Total 300

Item Writing and Review

There are 267 original items across the four (4) subscales that were subjected for review by three (3) experts, one a measurement specialist, a psychologist, and another one who is a teaching faculty in nursing.

The item review matrix was made for the reviewers to indicate their comments (see Appendix A). The items were evaluated in terms of their clarity and relevance vis-a-vis their conceptual definitions based on the various subscales. A decision whether to retain, revise or

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reject an item was done through agreement among the comments of the item reviewers. Pre-test Administration

The pre-testing of the NQS was conducted among groups consisting of 167 nursing students in their third year level. The test was administered through group testing to capture a maximum number of target respondents.

Permission from school to pre-test the instrument was sought first before conducting the pre-testing proper. Ethical considerations in testing and confidentiality of the test data were ensured prior to and after the test administration.

Establishing Validity and Reliability

Content validity of the NQS was established through the item review of experts. Its reliability, on the other hand, was be established through item analysis to be processed with the use of both classical (Cronbach’s alpha and factor analysis) and IRT methods (Rasch model). Assembly of the Final Form

Based on the results of the item analysis, the final form of the NSQ was assembled to retain good items each of the four subscales, totaling to 150 items. Parallel form was assembled depending on the number of acceptable and good items retained after the item analysis.

Interpretation of Scores

Table 2 presents the interpretative guide for the NQS. It must be noted that reverse scoring was done for the negatively-stated items before final scoring was computed. Mean scores per subscale was finally obtained with corresponding descriptive interpretation.

Table 2

Interpretative Guide for the NQS

Scale-Points

Continuum of Values Interpretation

4 (SA) 3.50 – 4.00 Most likely to manifest the traits/attributes

3 (A) 2.50 – 3.49 Likely to manifest the traits/attributes

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2 (D) 1.50 – 2.49 Unlikely to manifest the traits/attributes

1 (SD) 1.00 – 1.49 Least unlikely to manifest the traits/attributes

Note: SA=strongly agree, A=agree, D=disagree, SD=strongly disagree

Timelines

The test development was undertaken within six (6) months; specific timelines are shown in Table 3.

Table 3

Timelines of the NQS Development

Activity Duration

Item writing and review Three (3) monthsPre-testing One (1) monthItem analysis One (1) monthFinal Assembly One (1) month

Results

Internal Consistency

The tests reliability for the two forms was determined using Cronbach’s alpha. The total mean score for form A is 268.46 and a standard deviation of 29.40 with a corresponding mean of 1.902 when divided by the number of items. This shows that the responses of the nursing students are somehow low. The standardized Cronbach’s alpha arrived is .95 which indicates very high internal consistency among the items. For Form B, a mean score of 281 and a standard deviation of 35.16 with a corresponding score of 1.87 which is somehow low. The Cronbach’s alpha derived is .96 which indicates again a high reliability. In determining the reliability, the items for the two forms shows consistency of both having high reliability. Interitem correlation was also conducted top establish the consistency of the items with each other (see Appendix D).

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Factor Analysis

Factor analysis was performed to determine the sources of variation for the two forms of the NQS. In the procedure, the items were extracted in four factors fitting with the hypothesized factors in the study (compassion, commitment, caring, connectedness). The extracted communalities for each item were also determined (See appendix E). The items were clustered into four factors using varimax rotation with the eigenvalues of 26.36 for factor 1, 8.95 for factor 2, 4.09 for factor 3, and 3.81 for factor 4. The total eigenvalues for the extracted factors are shown in table 4.

Table 4

Eigenvalues of Form A Rotated Factors

Factors TotalPercentage of

VarianceCumulative Percentage

1 26.36 17.57 17.572 8.924 5.95 23.523 4.10 2.73 26.264 3.81 2.54 28.80

In the varimax rotation, items with factor loadings of .3 and above were accepted that composes the final pool of items in the instrument. The following items for each factor are shown in Tables 5 - 7.

Table 5

Accepted Items for Factor 1

Item no.

Item Factor loading

9 I am able to encourage people get better 0.3011 I am sensitive to the feelings of others 0.4613 To make sure a sick person feel comfortable is something I

would like to do0.32

16 I have a sense of connection with the people I meet 0.6123 I react appropriately to others’ facial expressions 0.3724 I treat my friends as my relatives 0.4627 I can guess what others are feeling through their gestures 0.5228 I believe that I am remembered by the good deeds that I do 0.5131 I can feel with people who are hurt 0.6832 I believe I am valued by other people 0.4933 I like entertaining guests 0.36

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35 I delight in others’ achievements 0.3240 I feel that my friends are close to me 0.3841 I like to accompany lame people to places theya re going 0.5147 I can feel if someone is hurting 0.6248 Other people get along with me 0.4249 I have fun telling stories to young people 0.4951 I can easily detect that someone is feeling bad 0.6453 I enjoy doing errands for my parents 0.3656 I am comfortable others depend on me 0.3761 I love to hug people who are close to me 0.3669 I am able to show affection to persons I care 0.3893 I get along well with others even to people whom I meet for the

first time0.54

95 I love to keep good company to people who are hurting. 0.3997 I love to tell jokes to a crowd 0.3799 I find time to listen to the hurt feelings of others 0.39107 I easily feel for the underdog in the movies 0.32108 I feel that there are a lot of qualities that people like in me. 0.56112 I treat my friends as family 0.40116 I have a sense of belongingness in school 0.61121 I enjoy taking care of my pets 0.30128 I feel that I am one with my classmates 0.45129 I make sure that everyone at home is comfortable 0.40135 I never get tired of talking to people who need my help 0.50136 I feel that I share a common career goal with my teachers 0.44145 When doing a task, I often do more than what is demanded 0.33148 I get excited whenever I am able to get through my message in

a conversation0.47

149 I readily foresee the actions and consequences of troubled people

0.36

150 I always try to share and suggest improvements on how things are done

0.54

Table 6

Accepted Items for Factor 2

Item no.

Item Factor loading

5 I ask my parents the things they need if they are sick 0.3821 I help feed my younger siblings when necessary 0.3622 I know I can reach my career goal 0.5526 I am aware that my career goal of becoming a nurse is worth

achieving for0.35

42 I love nursing because I feel that I would be good at it 0.4554 I am willing to volunteer to community projects 0.5157 I love to take care of sick people 0.4966 When given a task, I make sure it is accomplished on time 0.4667 I am happy for people who are able to achieve their goals 0.6270 I am willing to pursue further studies after I graduate from

college0.36

75 I am happy for people who become successful 0.5579 I get excited to see others win in their game 0.31102 I will take full responsibility for whatever actions I would take in 0.54

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becoming a good nurse114 I see myself as a dedicated nurse someday 0.57127 I believe that I need to be kind to others otherwise they will

treat me unfairly0.31

130 When given a task, I do it completely and thoroughly 0.46134 I am highly concerned for a sick member of the family 0.41138 I am willing to share similar experiences to others in distress 0.33

Table 7

Accepted Items for Factor 3

Item no.

Item Factor loading

3 I find it hard to read facial expressions -0.598 I can be a good friend to anyone 0.4514 I believe that not much could be gained by pursuing a nursing

degree-0.47

15 I listen to someone else’s point of view 0.3819 I am concerned when someone is treated unkindly 0.3343 I listen to others who ask for my help 0.4744 I feel secure with my family 0.5455 I hate talking to people who are in pain -0.5559 I do not like to listen to others’ hurts because I easily got

carried away by their emotions -0.62

68 I get uneasy when someone gets too close to me -0.5976 I am scared getting close to someone -0.5281 I am not able to open up to new acquaintances -0.3584 I do not feel comfortable being intimate with others -0.3789 I do not like to listen attentively to other people’s miseries and

sorrows-0.65

92 I feel others are reluctant to be close to me -0.4296 I feel people get readily intimidated with me -0.55111 I feel like wining too, when I see my team winning in a game 0.30120 I can easily identify myself with the nursing profession 0.59139 I am willing to share similar experiences to others in distress 0.30

Table 8

Accepted Items for Factor 4

Item no.

Item Factor loading

7 I get upset when someone else is sad 0.3518 I have a sense of connection with the people I meet 0.3683 I take on other people’s problems as if they are my own 0.41103 I shrink back when I see the hero hurt in the movies 0.30104 I worry if my close friends abandon me 0.40115 I cry easily when I see someone crying 0.58

Factor analysis was also conducted for Form B extracting four factors through varimax rotation. The extraction of communalities are

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also conducted (see appendix F). The eigenvalues are 32.51 for factor 1, 9.36 for factor 2, 4.80 for factor 3, and 3.86 for factor 4. The explained variance are high and using the scree test they are above 1.

Table 9

Eigenvalues of Form B Rotated Factors

Factors Total % of Variance Cumulative %1 32.51 21.67 21.672 9.36 6.24 27.913 4.80 3.20 31.114 3.86 2.57 33.69

The accepted items for the factors are shown in table 13. The items with factor loadings of .30 and above are accepted.

Table 13

Accepted Items for Factor 1

Item no.

Item Factor loading

7 I can easily identify myself with the nursing profession 0.6110 I spend a lot of time conversing with my family 0.3816 I show my concern when there is someone sick in the family 0.6625 I make sure that everyone in the family eat good healthy meals 0.5127 I enjoy making friends 0.6428 I will take care of my parents when they grow old 0.6230 I enjoy building good relationships with others 0.6031 I am lucky because I have warm and affectionate parents 0.4836 I love to join community projects 0.4637 I believe there is hope for a bright future for my loved ones 0.5949 I enjoy spending time with people I care for 0.5651 I will work hard to become a good burse 0.6968 I trust myself to do right things correctly 0.5875 I love family gatherings 0.4178 The nursing profession has a great deal of meaning to me 0.5182 I would be very happy to spend the rest of my career in the

nursing profession0.59

88 I lose my patience with people who are slow -0.3893 I show my real feelings towards other people 0.4995 Whenever a family crisis arises, I have someone whom I trust

could give me good advice0.40

98 My chosen career plays a central role in my life 0.35108 I inspire others to work for their goals 0.49

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110 I believe that I will be a successful nurse 0.69118 I exert more effort in teamwork to attain the goals 0.47121 I always consider what more I can do to advance in my chosen

career0.45

125 I can easily forgive and forget other people’s misgivings 0.36130 I pledge to do all things to the fullest as required by my

profession0.61

132 I believe that I have a great obligation to society 0.54135 I respect the uniqueness of each individual 0.56136 I give more than one hundred percent of my service 0.53140 I love being a nursing student 0.71142 I enjoy the activities and duties of a nursing student 0.71143 I am determined to finish my nursing course and become a

great nurse someday0.65

144 I hate rules and regulations -0.63148 I consider my trials in life as challenges 0.57150 I welcome new experiences 0.52

Table 14

Accepted Items for Factor 2

Item no.

Item Factor loading

2 I enjoy talking to people 0.4417 I never get tired of talking to people who need my help 0.4920 I am willing to share my similar stories to others in distress 0.3721 I have a strong urge to bond with people whom I feel are good

people 0.35

24 I love to mingle with people from all walks of life 0.6129 I am happy to know that I am fully understood by others even

when I am in trouble 0.44

32 I get excited whenever I am able to get my message across in a conversation

0.48

35 I readily foresee the actions and consequences of troubled people

0.50

38 I admire others’ active self-healing efforts when they are in trouble

0.62

54 I can easily see the faults and failures of others 0.3257 I believe that it is okay to commit mistakes 0.3363 I feel I have so much to give to help others in need 0.4864 I feel that people are glad to throw a party form me 0.5067 I am aware I am very capable of helping others 0.5370 I love working long hours because I find personal satisfaction in

seeing things get done0.34

85 I accept my friends unconditionally 0.4886 I enjoy discussing about my chosen profession even to others

who are not into it0.37

111 When meeting new people, I make sure to call them by name 0.33

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124 I stay with people who are in critical condition 0.51129 I affirm the positive traits of others 0.60134 I have a sense of pride with what I do 0.51138 I make sure that others come first in everything I do 0.55

Table 15

Accepted Items for Factor 3

Item no.

Item Factor loading

14 I can easily sense the pain and sorrow of others 0.4618 I feel that I share a common career goal with my teachers 0.4164 I feel that people are glad to throw a party for me 0.3572 I believe that other people’s needs are more important than

mine0.49

77 I feel what other people are feeling 0.6290 I feel I have few options If I leave my chosen career -0.40100 I refrain from saying things that would ridicule others 0.30101 I can easily place myself in the shoes of others 0.52103 I think my sense of humor makes me popular 0.51104 I show a calm and smiling face to anyone I come across with 0.31107 I get along well with people even those I meet for the first time 0.52113 I make sure that my friend feels accepted by my peers 0.38117 I do all that is necessary for the benefit of my friends 0.42119 I am not personally interested in other people’s lives -0.35139 I stay out of other people’s personal problems -0.30

Table 16

Accepted Items for Factor 4

Item no.

Item Factor loading

1 I do not bother listening to other people’s hurt feelings 0.4315 I believe that my classmates and I have common career goals 0.3243 I do not want getting stressed at doing an assigned task so I

perform like everybody else0.32

44 I do not need anyone to fulfill my career goal 0.4358 I find it difficult to commit in a relationship 0.3871 When I have problems, I have nobody whom I feel I will be

comfortable to talk with 0.43

73 I easily get drained with the bad feelings of others 0.3183 I feel I am often out of place in my circle of friends 0.4891 I find trouble in getting someone whom I can turn to for

personal problems0.43

94 I am not afraid of consequences if I quit my schooling in nursing 0.3997 I hate pretentious people -0.31102 I believe that my nursing course is a matter of necessity as

much as a desire0.51

133 I make fun of other people who are different 0.66146 I am fond of giving excuses whwnver things go wrong 0.46

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Item Calibration

The items for each factor were calibrated for the qualities that the participants have in the NQS test. For the items for both form A and B, the items that show properly fit with the quality based on the t values which is not significantly different from 0 are accepted in the final form. There are few items that show extreme calibration. Each scale was calibrated for items and by person. As compared in the factor analysis. There are more items that are accepted than in the IRT analysis using the Rasch model.

Table 17

Item Calibration for Caring Form A

item name

Itemscor

e

Item

freq.

prop.

corr.

Prop.

Incur.

logitincor

.freq.xlog

itfreq.xlogit^

2

init.delta

expansion

delta

Cal.SE

5 166 1 0.99 0.01-

5.11 -5.11 26.13-

2.89 1.09-

3.151.05

28 165 1 0.99 0.01-

4.41 -4.41 19.47-

2.19 1.09-

2.390.74

26 164 1 0.98 0.02-

4.00 -4.00 16.01-

1.78 1.09-

1.940.61

4 163 1 0.98 0.02-

3.71 -3.71 13.75-

1.48 1.09-

1.620.53

3,15 162 2 0.97 0.03-

3.48 -6.96 24.20-

1.25 1.09-

1.370.47

8,22 160 2 0.96 0.04-

3.13 -6.26 19.58-

0.91 1.09-

0.990.40

7 159 1 0.95 0.05-

2.99 -2.99 8.94-

0.77 1.09-

0.840.38

23,21,10 157 3 0.94 0.06

-2.75 -8.26 22.75

-0.53 1.09

-0.58

0.34

27 156 1 0.93 0.07-

2.65 -2.65 7.03-

0.43 1.09-

0.470.33

6,20 154 2 0.92 0.08-

2.47 -4.94 12.22-

0.25 1.09-

0.270.30

2 153 1 0.92 0.08-

2.39 -2.39 5.72-

0.17 1.09-

0.180.29

18,12 152 2 0.91 0.09-

2.32 -4.63 10.73-

0.09 1.09-

0.100.28

13 151 1 0.90 0.10-

2.24 -2.24 5.04-

0.02 1.09-

0.020.27

9 149 1 0.89 0.11-

2.11 -2.11 4.47 0.11 1.09 0.120.26

16 146 1 0.87 0.13-

1.94 -1.94 3.76 0.28 1.09 0.310.24

29 143 1 0.86 0.14-

1.78 -1.78 3.19 0.44 1.09 0.480.23

17

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17 142 1 0.85 0.15-

1.74 -1.74 3.02 0.49 1.09 0.530.23

11 141 1 0.84 0.16-

1.69 -1.69 2.86 0.53 1.09 0.580.22

25 140 1 0.84 0.16-

1.65 -1.65 2.71 0.58 1.09 0.630.22

32,14 137 2 0.82 0.18-

1.52 -3.04 4.61 0.70 1.09 0.770.21

33 123 1 0.74 0.26-

1.03 -1.03 1.06 1.20 1.09 1.300.18

24 121 1 0.72 0.28-

0.97 -0.97 0.94 1.26 1.09 1.370.18

1 120 1 0.72 0.28-

0.94 -0.94 0.88 1.29 1.09 1.400.18

31 101 1 0.60 0.40-

0.43 -0.43 0.18 1.80 1.09 1.960.17

19 43 1 0.26 0.74 1.06 1.06 1.12 3.28 1.09 3.580.18

30 32 1 0.19 0.81 1.44 1.44 2.07 3.66 1.09 3.990.21

Table 18

Person Calibration for Caring Form A

Possible score

person freq.

prop.corr.

logitcorrect freq.xlogit freq.xlogit^2

init. ability

Testwidth

Exp.Factor Beta Cal. SE

1 0 0.03 -3.47 0.00 0.00 -3.47 1.33 -4.60 1.17

2 0 0.06 -2.74 0.00 0.00 -2.74 1.33 -3.64 0.84

3 0 0.09 -2.30 0.00 0.00 -2.30 1.33 -3.06 0.70

4 0 0.12 -1.98 0.00 0.00 -1.98 1.33 -2.63 0.61

5 0 0.15 -1.72 0.00 0.00 -1.72 1.33 -2.29 0.56

6 0 0.18 -1.50 0.00 0.00 -1.50 1.33 -2.00 0.52

7 0 0.21 -1.31 0.00 0.00 -1.31 1.33 -1.74 0.49

8 0 0.24 -1.14 0.00 0.00 -1.14 1.33 -1.51 0.47

9 0 0.27 -0.98 0.00 0.00 -0.98 1.33 -1.30 0.45

10 0 0.30 -0.83 0.00 0.00 -0.83 1.33 -1.11 0.44

11 0 0.33 -0.69 0.00 0.00 -0.69 1.33 -0.92 0.43

12 0 0.36 -0.56 0.00 0.00 -0.56 1.33 -0.74 0.42

13 0 0.39 -0.43 0.00 0.00 -0.43 1.33 -0.57 0.41

14 0 0.42 -0.31 0.00 0.00 -0.31 1.33 -0.41 0.41

15 0 0.45 -0.18 0.00 0.00 -0.18 1.33 -0.24 0.40

16 0 0.48 -0.06 0.00 0.00 -0.06 1.33 -0.08 0.40

17 1 0.52 0.06 0.06 0.00 0.06 1.33 0.08 0.40

18 0 0.55 0.18 0.00 0.00 0.18 1.33 0.24 0.40

19 0 0.58 0.31 0.00 0.00 0.31 1.33 0.41 0.41

20 1 0.61 0.43 0.43 0.19 0.43 1.33 0.57 0.41

21 1 0.64 0.56 0.56 0.31 0.56 1.33 0.74 0.42

22 3 0.67 0.69 2.08 1.44 0.69 1.33 0.92 0.43

23 2 0.70 0.83 1.67 1.39 0.83 1.33 1.11 0.44

24 7 0.73 0.98 6.87 6.73 0.98 1.33 1.30 0.45

25 4 0.76 1.14 4.56 5.19 1.14 1.33 1.51 0.47

18

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26 13 0.79 1.31 17.06 22.38 1.31 1.33 1.74 0.49

27 25 0.82 1.50 37.60 56.56 1.50 1.33 2.00 0.52

28 26 0.85 1.72 44.79 77.17 1.72 1.33 2.29 0.56

29 37 0.88 1.98 73.30 145.20 1.98 1.33 2.63 0.61

30 33 0.91 2.30 75.99 174.96 2.30 1.33 3.06 0.70

31 11 0.94 2.74 30.15 82.63 2.74 1.33 3.64 0.84

32 3 0.97 3.47 10.40 36.03 3.47 1.33 4.60 1.17

Table 19

Item Calibration for Caring Form B

tem name

item scor

e

item

freq.

prop.

corr.

prop.

incor.

logit incor

.freq.xlog

itfreq.xlogit^

2

init.delta

expansion

delta

Cal. SE

22 150 1 0.99 0.01-

5.01 -5.01 25.11-

2.57 1.17-

3.001.0

8

8 148 1 0.98 0.02-

3.90 -3.90 15.20-

1.46 1.17-

1.700.6

3

9,19 147 2 0.97 0.03-

3.60 -7.21 25.98-

1.17 1.17-

1.360.5

5

5,20 146 2 0.97 0.03-

3.37 -6.75 22.77-

0.94 1.17-

1.090.4

9

4,24 145 2 0.96 0.04-

3.18 -6.37 20.29-

0.75 1.17-

0.870.4

5

7 144 1 0.95 0.05-

3.02 -3.02 9.14-

0.59 1.17-

0.680.4

2

23,16 143 2 0.95 0.05-

2.88 -5.77 16.63-

0.45 1.17-

0.520.3

9

11 142 1 0.94 0.06-

2.76 -2.76 7.61-

0.32 1.17-

0.370.3

7

14 141 1 0.93 0.07-

2.65 -2.65 7.00-

0.21 1.17-

0.240.3

5

10 140 1 0.93 0.07-

2.54 -2.54 6.47-

0.11 1.17-

0.120.3

4

15 136 1 0.90 0.10-

2.20 -2.20 4.86 0.23 1.17 0.270.2

9

1 135 1 0.89 0.11-

2.13 -2.13 4.55 0.30 1.17 0.360.2

9

21,18 133 2 0.88 0.12-

2.00 -4.00 8.00 0.44 1.17 0.510.2

7

12 130 1 0.86 0.14-

1.82 -1.82 3.32 0.61 1.17 0.720.2

5

17 129 1 0.85 0.15-

1.77 -1.77 3.13 0.67 1.17 0.780.2

5

13 125 1 0.83 0.17-

1.57 -1.57 2.47 0.87 1.17 1.010.2

3

6,3 124 2 0.82 0.18-

1.52 -3.05 4.65 0.91 1.17 1.070.2

3

25 105 1 0.70 0.30-

0.83 -0.83 0.68 1.61 1.17 1.880.1

9

2 102 1 0.68 0.32-

0.73 -0.73 0.54 1.70 1.17 1.990.1

9

19

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26 50 1 0.33 0.67 0.70 0.70 0.49 3.14 1.17 3.660.1

9Table 20

Person Calibration for Caring Form B

possible

score

person

freq.prop.corr.

logit correct

freq.xlogit

freq.xlogit^2

init.abilit

y

Testwidt

hExp.

Factor BetaCal.SE

1 0 0.04 -3.22 0.00 0.00 -3.22 1.28-

4.13 1.16

2 0 0.08 -2.48 0.00 0.00 -2.48 1.28-

3.19 0.83

3 0 0.12 -2.04 0.00 0.00 -2.04 1.28-

2.61 0.70

4 0 0.15 -1.70 0.00 0.00 -1.70 1.28-

2.19 0.62

5 0 0.19 -1.44 0.00 0.00 -1.44 1.28-

1.84 0.56

6 0 0.23 -1.20 0.00 0.00 -1.20 1.28-

1.55 0.53

7 0 0.27 -1.00 0.00 0.00 -1.00 1.28-

1.28 0.50

8 0 0.31 -0.81 0.00 0.00 -0.81 1.28-

1.04 0.48

9 0 0.35 -0.64 0.00 0.00 -0.64 1.28-

0.82 0.47

10 0 0.38 -0.47 0.00 0.00 -0.47 1.28-

0.60 0.46

11 0 0.42 -0.31 0.00 0.00 -0.31 1.28-

0.40 0.45

12 0 0.46 -0.15 0.00 0.00 -0.15 1.28-

0.20 0.4513 1 0.50 0.00 0.00 0.00 0.00 1.28 0.00 0.4414 0 0.54 0.15 0.00 0.00 0.15 1.28 0.20 0.4515 2 0.58 0.31 0.62 0.19 0.31 1.28 0.40 0.4516 1 0.62 0.47 0.47 0.22 0.47 1.28 0.60 0.4617 1 0.65 0.64 0.64 0.40 0.64 1.28 0.82 0.4718 2 0.69 0.81 1.62 1.32 0.81 1.28 1.04 0.4819 2 0.73 1.00 2.00 1.99 1.00 1.28 1.28 0.5020 10 0.77 1.20 12.04 14.50 1.20 1.28 1.55 0.5321 17 0.81 1.44 24.40 35.01 1.44 1.28 1.84 0.5622 17 0.85 1.70 28.98 49.40 1.70 1.28 2.19 0.6223 22 0.88 2.04 44.81 91.28 2.04 1.28 2.61 0.7024 34 0.92 2.48 84.49 209.94 2.48 1.28 3.19 0.8325 42 0.96 3.22 135.19 435.17 3.22 1.28 4.13 1.16

Table 21

Item Calibration for Commitment Form A

20

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Nursing Quality Scale

itemname

Itemscor

e

Itemfreq.

prop.

corr.

prop.

incor.

logitinco

r.freq.xlo

gitfreq.xlogit

^2

init.delta

expansion

delta

Cal. SE

29,1 164 2 0.99 0.01-

5.10 -10.20 52.02-

2.32 1.18-

2.73 1.097,4,30,2

1 163 4 0.99 0.01-

4.40 -17.60 77.46-

1.62 1.18-

1.91 0.77

23 162 1 0.98 0.02-

3.99 -3.99 15.91-

1.21 1.18-

1.42 0.639,33,27,

26 161 4 0.98 0.02-

3.70 -14.78 54.62-

0.92 1.18-

1.08 0.55

25,10 160 2 0.97 0.03-

3.47 -6.93 24.02-

0.69 1.18-

0.81 0.49

8,3,2 159 3 0.96 0.04-

3.28 -9.83 32.22-

0.50 1.18-

0.59 0.45

6,24,13 158 3 0.96 0.04-

3.12 -9.35 29.14-

0.34 1.18-

0.40 0.42

19,17 156 2 0.95 0.05-

2.85 -5.71 16.28-

0.07 1.18-

0.09 0.37

22 155 1 0.94 0.06-

2.74 -2.74 7.51 0.04 1.18 0.04 0.35

14 154 1 0.93 0.07-

2.64 -2.64 6.96 0.14 1.18 0.16 0.34

16 152 1 0.92 0.08-

2.46 -2.46 6.05 0.32 1.18 0.38 0.31

28,20,15 148 3 0.90 0.10-

2.16 -6.49 14.05 0.61 1.18 0.72 0.28

31 140 1 0.85 0.15-

1.72 -1.72 2.97 1.06 1.18 1.24 0.24

12,11 139 2 0.84 0.16-

1.68 -3.35 5.62 1.10 1.18 1.30 0.23

37 135 1 0.82 0.18-

1.50 -1.50 2.26 1.27 1.18 1.50 0.22

18 128 1 0.78 0.22-

1.24 -1.24 1.54 1.54 1.18 1.81 0.20

35 125 1 0.76 0.24-

1.14 -1.14 1.30 1.64 1.18 1.93 0.20

34 119 1 0.72 0.28-

0.95 -0.95 0.90 1.83 1.18 2.15 0.19

36 101 1 0.61 0.39-

0.46 -0.46 0.21 2.32 1.18 2.73 0.17

5 90 1 0.55 0.45-

0.18 -0.18 0.03 2.60 1.18 3.05 0.17

32 64 1 0.39 0.61 0.46 0.46 0.21 3.23 1.18 3.80 0.17

Table 22

Person Calibration for Commitment Form A

possible score

person freq.

prop. corr.

logit correct freq.xlogit Freq.xlogit^2

init.ability

Test width

Exp.Factor BetaCal.SE

1 0 0.03 -3.58 0.00 0.00 -3.58 1.37 -4.90 1.19

2 0 0.05 -2.86 0.00 0.00 -2.86 1.37 -3.91 0.85

3 0 0.08 -2.43 0.00 0.00 -2.43 1.37 -3.32 0.70

4 0 0.11 -2.11 0.00 0.00 -2.11 1.37 -2.89 0.62

21

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5 0 0.14 -1.86 0.00 0.00 -1.86 1.37 -2.54 0.56

6 0 0.16 -1.64 0.00 0.00 -1.64 1.37 -2.25 0.52

7 0 0.19 -1.46 0.00 0.00 -1.46 1.37 -1.99 0.49

8 0 0.22 -1.29 0.00 0.00 -1.29 1.37 -1.76 0.47

9 0 0.24 -1.13 0.00 0.00 -1.13 1.37 -1.55 0.45

10 0 0.27 -0.99 0.00 0.00 -0.99 1.37 -1.36 0.43

11 0 0.30 -0.86 0.00 0.00 -0.86 1.37 -1.18 0.42

12 0 0.32 -0.73 0.00 0.00 -0.73 1.37 -1.00 0.41

13 0 0.35 -0.61 0.00 0.00 -0.61 1.37 -0.84 0.40

14 0 0.38 -0.50 0.00 0.00 -0.50 1.37 -0.68 0.40

15 0 0.41 -0.38 0.00 0.00 -0.38 1.37 -0.52 0.39

16 0 0.43 -0.27 0.00 0.00 -0.27 1.37 -0.37 0.39

17 0 0.46 -0.16 0.00 0.00 -0.16 1.37 -0.22 0.39

18 0 0.49 -0.05 0.00 0.00 -0.05 1.37 -0.07 0.38

19 0 0.51 0.05 0.00 0.00 0.05 1.37 0.07 0.38

20 0 0.54 0.16 0.00 0.00 0.16 1.37 0.22 0.39

21 0 0.57 0.27 0.00 0.00 0.27 1.37 0.37 0.39

22 0 0.59 0.38 0.00 0.00 0.38 1.37 0.52 0.39

23 1 0.62 0.50 0.50 0.25 0.50 1.37 0.68 0.40

24 2 0.65 0.61 1.23 0.75 0.61 1.37 0.84 0.40

25 1 0.68 0.73 0.73 0.54 0.73 1.37 1.00 0.41

26 2 0.70 0.86 1.72 1.48 0.86 1.37 1.18 0.42

27 3 0.73 0.99 2.98 2.96 0.99 1.37 1.36 0.43

28 7 0.76 1.13 7.94 9.02 1.13 1.37 1.55 0.45

29 5 0.78 1.29 6.44 8.29 1.29 1.37 1.76 0.47

30 3 0.81 1.46 4.37 6.35 1.46 1.37 1.99 0.49

31 7 0.84 1.64 11.50 18.88 1.64 1.37 2.25 0.52

32 17 0.86 1.86 31.56 58.58 1.86 1.37 2.54 0.56

33 28 0.89 2.11 59.09 124.68 2.11 1.37 2.89 0.62

34 31 0.92 2.43 75.26 182.71 2.43 1.37 3.32 0.70

35 33 0.95 2.86 94.45 270.34 2.86 1.37 3.91 0.85

36 25 0.97 3.58 89.59 321.04 3.58 1.37 4.90 1.19

Table 23

Item Calibration for Commitment Form B

Itemname

Itemscore

Itemfreq.

prop.corr.

prop.incor.

Logitincor. freq.xlogit freq.xlogit^2

init.delta expansion delta

Cal. SE

36,31,18,16 166 4 0.99 0.01 -5.11 -20.45 104.53 -2.44 1.16 -2.82 1.088,30,2

9,2 165 4 0.99 0.01 -4.41 -17.65 77.89 -1.74 1.16 -2.01 0.77

5,34 164 2 0.98 0.02 -4.00 -8.00 32.02 -1.32 1.16 -1.53 0.63

23,21 163 2 0.98 0.02 -3.71 -7.41 27.49 -1.03 1.16 -1.19 0.54

35,22 162 2 0.97 0.03 -3.48 -6.96 24.20 -0.80 1.16 -0.93 0.49

20 161 1 0.96 0.04 -3.29 -3.29 10.82 -0.61 1.16 -0.71 0.456,3,28,19,17,

13 160 6 0.96 0.04 -3.13 -18.78 58.75 -0.45 1.16 -0.52 0.42

33 158 1 0.95 0.05 -2.87 -2.87 8.21 -0.19 1.16 -0.22 0.37

22

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25 157 1 0.94 0.06 -2.75 -2.75 7.58 -0.08 1.16 -0.09 0.35

9 155 1 0.93 0.07 -2.56 -2.56 6.55 0.12 1.16 0.14 0.32

4,32 151 2 0.90 0.10 -2.24 -4.49 10.08 0.43 1.16 0.50 0.28

27 145 1 0.87 0.13 -1.89 -1.89 3.56 0.79 1.16 0.92 0.25

7,26 143 2 0.86 0.14 -1.78 -3.57 6.37 0.89 1.16 1.03 0.24

1 142 1 0.85 0.15 -1.74 -1.74 3.02 0.94 1.16 1.09 0.23

41,24 138 2 0.83 0.17 -1.56 -3.12 4.87 1.12 1.16 1.29 0.22

11,10 136 2 0.81 0.19 -1.48 -2.96 4.37 1.20 1.16 1.39 0.21

39 132 1 0.79 0.21 -1.33 -1.33 1.76 1.35 1.16 1.56 0.20

15 123 1 0.74 0.26 -1.03 -1.03 1.06 1.65 1.16 1.91 0.19

14 119 1 0.71 0.29 -0.91 -0.91 0.82 1.77 1.16 2.05 0.18

12 108 1 0.65 0.35 -0.60 -0.60 0.37 2.07 1.16 2.40 0.17

38 100 1 0.60 0.40 -0.40 -0.40 0.16 2.28 1.16 2.63 0.17

40 97 1 0.58 0.42 -0.33 -0.33 0.11 2.35 1.16 2.72 0.17

42 75 1 0.45 0.55 0.20 0.20 0.04 2.88 1.16 3.33 0.17

37 65 1 0.39 0.61 0.45 0.45 0.20 3.13 1.16 3.62 0.17

Table 24

Person Calibration for Commitment Form B

Possible score

person

freq.prop. corr.

logit correc

tfreq.xlogi

tfreq.xlogit^

2init.

abilityTest width

Exp.Factor Beta

Cal. SE

1 0 0.02 -3.71 0.00 0.00 -3.71 1.44-

5.331.21

2 0 0.05 -3.00 0.00 0.00 -3.00 1.44-

4.300.87

3 0 0.07 -2.56 0.00 0.00 -2.56 1.44-

3.680.72

4 0 0.10 -2.25 0.00 0.00 -2.25 1.44-

3.230.63

5 0 0.12 -2.00 0.00 0.00 -2.00 1.44-

2.870.57

6 0 0.14 -1.79 0.00 0.00 -1.79 1.44-

2.570.53

7 0 0.17 -1.61 0.00 0.00 -1.61 1.44-

2.310.50

8 0 0.19 -1.45 0.00 0.00 -1.45 1.44-

2.080.47

9 0 0.21 -1.30 0.00 0.00 -1.30 1.44-

1.870.45

10 0 0.24 -1.16 0.00 0.00 -1.16 1.44-

1.670.43

23

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Nursing Quality Scale

11 0 0.26 -1.04 0.00 0.00 -1.04 1.44-

1.490.42

12 0 0.29 -0.92 0.00 0.00 -0.92 1.44-

1.320.41

13 0 0.31 -0.80 0.00 0.00 -0.80 1.44-

1.150.40

14 0 0.33 -0.69 0.00 0.00 -0.69 1.44-

1.000.39

15 0 0.36 -0.59 0.00 0.00 -0.59 1.44-

0.840.39

16 0 0.38 -0.49 0.00 0.00 -0.49 1.44-

0.700.38

17 0 0.40 -0.39 0.00 0.00 -0.39 1.44-

0.550.38

18 0 0.43 -0.29 0.00 0.00 -0.29 1.44-

0.410.37

19 0 0.45 -0.19 0.00 0.00 -0.19 1.44-

0.270.37

20 0 0.48 -0.10 0.00 0.00 -0.10 1.44-

0.140.37

21 0 0.50 0.00 0.00 0.00 0.00 1.44 0.000.37

22 0 0.52 0.10 0.00 0.00 0.10 1.44 0.140.37

23 0 0.55 0.19 0.00 0.00 0.19 1.44 0.270.37

24 1 0.57 0.29 0.29 0.08 0.29 1.44 0.410.37

25 2 0.60 0.39 0.77 0.30 0.39 1.44 0.550.38

26 1 0.62 0.49 0.49 0.24 0.49 1.44 0.700.38

27 1 0.64 0.59 0.59 0.35 0.59 1.44 0.840.39

28 0 0.67 0.69 0.00 0.00 0.69 1.44 1.000.39

29 2 0.69 0.80 1.60 1.29 0.80 1.44 1.150.40

30 0 0.71 0.92 0.00 0.00 0.92 1.44 1.320.41

31 5 0.74 1.04 5.18 5.37 1.04 1.44 1.490.42

32 2 0.76 1.16 2.33 2.71 1.16 1.44 1.670.43

33 3 0.79 1.30 3.90 5.06 1.30 1.44 1.870.45

34 11 0.81 1.45 15.92 23.03 1.45 1.44 2.080.47

35 18 0.83 1.61 28.97 46.63 1.61 1.44 2.310.50

36 14 0.86 1.79 25.08 44.95 1.79 1.44 2.570.53

37 33 0.88 2.00 66.05 132.20 2.00 1.44 2.870.57

38 18 0.90 2.25 40.52 91.23 2.25 1.44 3.230.63

39 28 0.93 2.56 71.82 184.21 2.56 1.44 3.680.72

40 21 0.95 3.00 62.91 188.46 3.00 1.44 4.300.87

41 7 0.98 3.71 26.00 96.53 3.71 1.44 5.331.21

24

Page 25: Nursing Quality Scale (NQS): Test Development

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Table 25

Item Calibration for Compassion Form A

item name

item score

Itemfreq.

prop.corr.

prop.incor.

Logit\incor. freq.xlogit freq.xlogit^2

init.delta expansion delta

Cal.SE

27 163 1 0.99 0.01 -5.09 -5.09 25.95 -3.00 1.18 -3.55 1.09

16,13 162 2 0.99 0.01 -4.39 -8.79 38.62 -2.30 1.18 -2.72 0.77

35,30,22 161 3 0.98 0.02 -3.98 -11.95 47.59 -1.89 1.18 -2.24 0.63

15 159 1 0.97 0.03 -3.46 -3.46 11.97 -1.37 1.18 -1.62 0.49

26 158 1 0.96 0.04 -3.27 -3.27 10.70 -1.18 1.18 -1.39 0.45

3 156 1 0.95 0.05 -2.97 -2.97 8.82 -0.88 1.18 -1.04 0.39

12 155 1 0.95 0.05 -2.85 -2.85 8.10 -0.75 1.18 -0.89 0.37

37,23 153 2 0.93 0.07 -2.63 -5.27 13.86 -0.54 1.18 -0.64 0.34

33,18 152 2 0.93 0.07 -2.54 -5.08 12.89 -0.45 1.18 -0.53 0.33

8 151 1 0.92 0.08 -2.45 -2.45 6.01 -0.36 1.18 -0.43 0.31

4,38 150 2 0.91 0.09 -2.37 -4.74 11.25 -0.28 1.18 -0.33 0.30

7,21 149 2 0.91 0.09 -2.30 -4.59 10.54 -0.20 1.18 -0.24 0.29

6 148 1 0.90 0.10 -2.22 -2.22 4.95 -0.13 1.18 -0.16 0.29

36,10 146 2 0.89 0.11 -2.09 -4.19 8.76 0.00 1.18 0.00 0.27

2 145 1 0.88 0.12 -2.03 -2.03 4.13 0.06 1.18 0.07 0.27

5 142 1 0.87 0.13 -1.86 -1.86 3.48 0.23 1.18 0.27 0.25

14 141 1 0.86 0.14 -1.81 -1.81 3.29 0.28 1.18 0.33 0.24

20 140 1 0.85 0.15 -1.76 -1.76 3.11 0.33 1.18 0.39 0.24

32 138 1 0.84 0.16 -1.67 -1.67 2.79 0.42 1.18 0.50 0.23

11 137 1 0.84 0.16 -1.62 -1.62 2.64 0.47 1.18 0.55 0.23

42 136 1 0.83 0.17 -1.58 -1.58 2.50 0.51 1.18 0.60 0.23

39,34 133 2 0.81 0.19 -1.46 -2.91 4.24 0.64 1.18 0.75 0.22

41,19 128 2 0.78 0.22 -1.27 -2.54 3.22 0.82 1.18 0.97 0.21

31 127 1 0.77 0.23 -1.23 -1.23 1.52 0.86 1.18 1.01 0.20

29 124 1 0.76 0.24 -1.13 -1.13 1.28 0.96 1.18 1.14 0.20

40,1 113 2 0.69 0.31 -0.80 -1.59 1.27 1.30 1.18 1.53 0.18

9 107 1 0.65 0.35 -0.63 -0.63 0.40 1.46 1.18 1.73 0.18

43 98 1 0.60 0.40 -0.40 -0.40 0.16 1.70 1.18 2.01 0.17

25 97 1 0.59 0.41 -0.37 -0.37 0.14 1.72 1.18 2.04 0.17

28 90 1 0.55 0.45 -0.20 -0.20 0.04 1.90 1.18 2.24 0.17

17 82 1 0.50 0.50 0.00 0.00 0.00 2.09 1.18 2.47 0.17

24 69 1 0.42 0.58 0.32 0.32 0.10 2.41 1.18 2.85 0.17

Table 26

Person Calibration for Compassion Form A

possible score

person freq.

Propcorr.

logit correct freq.xlogit freq.xlogit^2 init. ability Test width

Exp.Factor Beta Cal. SE

1 0 0.02 -3.74 0.00 0.00 -3.74 1.33 -4.96 1.17

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2 0 0.05 -3.02 0.00 0.00 -3.02 1.33 -4.01 0.833 0 0.07 -2.59 0.00 0.00 -2.59 1.33 -3.44 0.694 0 0.09 -2.28 0.00 0.00 -2.28 1.33 -3.02 0.605 0 0.12 -2.03 0.00 0.00 -2.03 1.33 -2.69 0.556 0 0.14 -1.82 0.00 0.00 -1.82 1.33 -2.41 0.517 0 0.16 -1.64 0.00 0.00 -1.64 1.33 -2.17 0.488 0 0.19 -1.48 0.00 0.00 -1.48 1.33 -1.96 0.459 0 0.21 -1.33 0.00 0.00 -1.33 1.33 -1.76 0.43

10 0 0.23 -1.19 0.00 0.00 -1.19 1.33 -1.58 0.4211 0 0.26 -1.07 0.00 0.00 -1.07 1.33 -1.42 0.4012 0 0.28 -0.95 0.00 0.00 -0.95 1.33 -1.26 0.3913 0 0.30 -0.84 0.00 0.00 -0.84 1.33 -1.11 0.3814 0 0.33 -0.73 0.00 0.00 -0.73 1.33 -0.97 0.3715 0 0.35 -0.62 0.00 0.00 -0.62 1.33 -0.83 0.3716 0 0.37 -0.52 0.00 0.00 -0.52 1.33 -0.69 0.3617 0 0.40 -0.42 0.00 0.00 -0.42 1.33 -0.56 0.3618 1 0.42 -0.33 -0.33 0.11 -0.33 1.33 -0.44 0.3619 0 0.44 -0.23 0.00 0.00 -0.23 1.33 -0.31 0.3520 0 0.47 -0.14 0.00 0.00 -0.14 1.33 -0.19 0.3521 1 0.49 -0.05 -0.05 0.00 -0.05 1.33 -0.06 0.3522 0 0.51 0.05 0.00 0.00 0.05 1.33 0.06 0.3523 0 0.53 0.14 0.00 0.00 0.14 1.33 0.19 0.3524 0 0.56 0.23 0.00 0.00 0.23 1.33 0.31 0.3525 2 0.58 0.33 0.66 0.22 0.33 1.33 0.44 0.3626 3 0.60 0.42 1.27 0.54 0.42 1.33 0.56 0.3627 0 0.63 0.52 0.00 0.00 0.52 1.33 0.69 0.3628 2 0.65 0.62 1.25 0.78 0.62 1.33 0.83 0.3729 2 0.67 0.73 1.46 1.06 0.73 1.33 0.97 0.3730 6 0.70 0.84 5.02 4.20 0.84 1.33 1.11 0.3831 6 0.72 0.95 5.69 5.40 0.95 1.33 1.26 0.3932 7 0.74 1.07 7.47 7.98 1.07 1.33 1.42 0.4033 13 0.77 1.19 15.52 18.53 1.19 1.33 1.58 0.4234 13 0.79 1.33 17.28 22.97 1.33 1.33 1.76 0.4335 6 0.81 1.48 8.86 13.07 1.48 1.33 1.96 0.4536 11 0.84 1.64 18.01 29.50 1.64 1.33 2.17 0.4837 14 0.86 1.82 25.47 46.33 1.82 1.33 2.41 0.5138 16 0.88 2.03 32.45 65.81 2.03 1.33 2.69 0.5539 23 0.91 2.28 52.38 119.28 2.28 1.33 3.02 0.6040 17 0.93 2.59 44.03 114.06 2.59 1.33 3.44 0.6941 15 0.95 3.02 45.31 136.84 3.02 1.33 4.01 0.8342 6 0.98 3.74 22.43 83.82 3.74 1.33 4.96 1.17

Table 27

Item Calibration for Compassion Form B

Itemname

item score

itemfreq.

prop.corr.

prop.incor.

Logitincor. freq.xlogit freq.xlogit^2

init.delta expansion delta

Cal.SE

32 165 1 0.99 0.01 -5.11 -5.11 26.07 -3.04 1.16 -3.53 1.08

1 164 1 0.99 0.01 -4.41 -4.41 19.42 -2.34 1.16 -2.72 0.77

6,19 163 2 0.98 0.02 -4.00 -7.99 31.92 -1.93 1.16 -2.24 0.63

26

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21 162 1 0.98 0.02 -3.70 -3.70 13.70 -1.64 1.16 -1.90 0.55

12 161 1 0.97 0.03 -3.47 -3.47 12.05 -1.41 1.16 -1.63 0.49

14 160 1 0.96 0.04 -3.28 -3.28 10.78 -1.22 1.16 -1.42 0.45

11 159 1 0.96 0.04 -3.12 -3.12 9.75 -1.06 1.16 -1.23 0.42

8,7,16 158 3 0.95 0.05 -2.98 -8.95 26.70 -0.92 1.16 -1.07 0.394,20,18,10 152 4 0.92 0.08 -2.38 -9.54 22.75 -0.32 1.16 -0.37 0.30

13 148 1 0.89 0.11 -2.11 -2.11 4.44 -0.04 1.16 -0.05 0.27

24 144 1 0.87 0.13 -1.88 -1.88 3.53 0.18 1.16 0.21 0.25

28 139 1 0.84 0.16 -1.64 -1.64 2.69 0.42 1.16 0.49 0.23

26 135 1 0.81 0.19 -1.47 -1.47 2.16 0.59 1.16 0.69 0.21

5 134 1 0.81 0.19 -1.43 -1.43 2.05 0.63 1.16 0.73 0.21

9,3 133 2 0.80 0.20 -1.39 -2.79 3.89 0.67 1.16 0.78 0.21

23 130 1 0.78 0.22 -1.28 -1.28 1.65 0.78 1.16 0.90 0.20

29,17 129 2 0.78 0.22 -1.25 -2.50 3.12 0.81 1.16 0.94 0.20

2 128 1 0.77 0.23 -1.21 -1.21 1.47 0.85 1.16 0.98 0.20

30 127 1 0.77 0.23 -1.18 -1.18 1.39 0.88 1.16 1.02 0.20

25 126 1 0.76 0.24 -1.15 -1.15 1.32 0.92 1.16 1.06 0.20

31 108 1 0.65 0.35 -0.62 -0.62 0.39 1.44 1.16 1.67 0.18

15 106 1 0.64 0.36 -0.57 -0.57 0.32 1.49 1.16 1.73 0.17

33 97 1 0.58 0.42 -0.34 -0.34 0.12 1.72 1.16 2.00 0.17

22 69 1 0.42 0.58 0.34 0.34 0.12 2.40 1.16 2.79 0.17

27 35 1 0.21 0.79 1.32 1.32 1.74 3.38 1.16 3.92 0.20

Table 28

Person Calibration for Compassion Form B

possible score

person freq.

prop.corr.

logit correct freq.xlogit freq.xlogit^2

init.ability

Test width

Exp.Factor Beta Cal. SE

1 0 0.03 -3.47 0.00 0.00 -3.47 1.38 -4.80 1.19

2 0 0.06 -2.74 0.00 0.00 -2.74 1.38 -3.80 0.86

3 0 0.09 -2.30 0.00 0.00 -2.30 1.38 -3.19 0.71

4 0 0.12 -1.98 0.00 0.00 -1.98 1.38 -2.74 0.63

5 0 0.15 -1.72 0.00 0.00 -1.72 1.38 -2.39 0.57

6 0 0.18 -1.50 0.00 0.00 -1.50 1.38 -2.08 0.53

7 0 0.21 -1.31 0.00 0.00 -1.31 1.38 -1.82 0.50

8 0 0.24 -1.14 0.00 0.00 -1.14 1.38 -1.58 0.48

9 0 0.27 -0.98 0.00 0.00 -0.98 1.38 -1.36 0.46

10 0 0.30 -0.83 0.00 0.00 -0.83 1.38 -1.15 0.45

11 0 0.33 -0.69 0.00 0.00 -0.69 1.38 -0.96 0.43

12 0 0.36 -0.56 0.00 0.00 -0.56 1.38 -0.77 0.43

13 1 0.39 -0.43 -0.43 0.19 -0.43 1.38 -0.60 0.42

14 0 0.42 -0.31 0.00 0.00 -0.31 1.38 -0.42 0.41

15 0 0.45 -0.18 0.00 0.00 -0.18 1.38 -0.25 0.41

16 0 0.48 -0.06 0.00 0.00 -0.06 1.38 -0.08 0.41

17 0 0.52 0.06 0.00 0.00 0.06 1.38 0.08 0.41

18 0 0.55 0.18 0.00 0.00 0.18 1.38 0.25 0.41

19 4 0.58 0.31 1.22 0.37 0.31 1.38 0.42 0.41

20 2 0.61 0.43 0.86 0.37 0.43 1.38 0.60 0.42

27

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21 3 0.64 0.56 1.68 0.94 0.56 1.38 0.77 0.43

22 2 0.67 0.69 1.39 0.96 0.69 1.38 0.96 0.43

23 7 0.70 0.83 5.83 4.86 0.83 1.38 1.15 0.45

24 9 0.73 0.98 8.83 8.66 0.98 1.38 1.36 0.46

25 12 0.76 1.14 13.67 15.58 1.14 1.38 1.58 0.48

26 22 0.79 1.31 28.87 37.88 1.31 1.38 1.82 0.50

27 16 0.82 1.50 24.07 36.20 1.50 1.38 2.08 0.53

28 15 0.85 1.72 25.84 44.52 1.72 1.38 2.39 0.57

29 25 0.88 1.98 49.53 98.11 1.98 1.38 2.74 0.63

30 27 0.91 2.30 62.17 143.15 2.30 1.38 3.19 0.71

31 15 0.94 2.74 41.11 112.68 2.74 1.38 3.80 0.86

32 6 0.97 3.47 20.79 72.07 3.47 1.38 4.80 1.19

Table 29

Item Calibration for Connectedness Form A

item name

Itemscore

Itemfreq.

prop.corr.

prop.incor.

logit incor. freq.xlogit

freq.xlogit^2

init. delta expansion delta

Cal. SE

23 165 1 0.99 0.01 -4.41 -4.41 19.47 -2.68 1.09 -2.92 0.748,24 160 2 0.96 0.04 -3.13 -6.26 19.58 -1.39 1.09 -1.52 0.4031,2 159 2 0.95 0.05 -2.99 -5.98 17.87 -1.25 1.09 -1.37 0.387,6 158 2 0.95 0.05 -2.87 -5.73 16.42 -1.13 1.09 -1.23 0.3612 157 1 0.94 0.06 -2.75 -2.75 7.58 -1.02 1.09 -1.11 0.34

5,14 156 2 0.93 0.07 -2.65 -5.30 14.07 -0.92 1.09 -1.00 0.3310 155 1 0.93 0.07 -2.56 -2.56 6.55 -0.82 1.09 -0.90 0.31

25,22 153 2 0.92 0.08 -2.39 -4.78 11.44 -0.66 1.09 -0.71 0.294,26 152 2 0.91 0.09 -2.32 -4.63 10.73 -0.58 1.09 -0.63 0.2811 151 1 0.90 0.10 -2.24 -2.24 5.04 -0.51 1.09 -0.56 0.273 149 1 0.89 0.11 -2.11 -2.11 4.47 -0.38 1.09 -0.41 0.26

28 148 1 0.89 0.11 -2.05 -2.05 4.21 -0.32 1.09 -0.35 0.251 146 1 0.87 0.13 -1.94 -1.94 3.76 -0.20 1.09 -0.22 0.24

27 145 1 0.87 0.13 -1.89 -1.89 3.56 -0.15 1.09 -0.16 0.249 143 1 0.86 0.14 -1.78 -1.78 3.19 -0.05 1.09 -0.05 0.23

29 139 1 0.83 0.17 -1.60 -1.60 2.57 0.13 1.09 0.15 0.2221 136 1 0.81 0.19 -1.48 -1.48 2.19 0.26 1.09 0.28 0.2130 135 1 0.81 0.19 -1.44 -1.44 2.07 0.30 1.09 0.32 0.2118 134 1 0.80 0.20 -1.40 -1.40 1.96 0.33 1.09 0.36 0.2020 131 1 0.78 0.22 -1.29 -1.29 1.67 0.44 1.09 0.48 0.2034 120 1 0.72 0.28 -0.94 -0.94 0.88 0.80 1.09 0.87 0.1835 117 1 0.70 0.30 -0.85 -0.85 0.72 0.89 1.09 0.96 0.1819 110 1 0.66 0.34 -0.66 -0.66 0.43 1.08 1.09 1.17 0.1732 105 1 0.63 0.37 -0.53 -0.53 0.28 1.21 1.09 1.32 0.1717 104 1 0.62 0.38 -0.50 -0.50 0.25 1.23 1.09 1.35 0.1716 102 1 0.61 0.39 -0.45 -0.45 0.20 1.28 1.09 1.40 0.1713 100 1 0.60 0.40 -0.40 -0.40 0.16 1.33 1.09 1.46 0.1636 99 1 0.59 0.41 -0.38 -0.38 0.14 1.36 1.09 1.48 0.1637 90 1 0.54 0.46 -0.16 -0.16 0.02 1.58 1.09 1.72 0.1633 50 1 0.30 0.70 0.85 0.85 0.72 2.59 1.09 2.82 0.1815 32 1 0.19 0.81 1.44 1.44 2.07 3.17 1.09 3.46 0.21

28

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Nursing Quality Scale

Table 30

Person Calibration for Connectedness Form A

possible score

person freq.

prop. corr. logit correct freq.xlogit freq.xlogit^2 init. ability Test width

Exp.Factor Beta Cal. SE

1 0 0.03 -3.58 0.00 0.00 -3.58 1.27 -4.54 1.142 0 0.05 -2.86 0.00 0.00 -2.86 1.27 -3.62 0.823 0 0.08 -2.43 0.00 0.00 -2.43 1.27 -3.07 0.684 0 0.11 -2.11 0.00 0.00 -2.11 1.27 -2.67 0.605 0 0.14 -1.86 0.00 0.00 -1.86 1.27 -2.35 0.546 0 0.16 -1.64 0.00 0.00 -1.64 1.27 -2.08 0.507 0 0.19 -1.46 0.00 0.00 -1.46 1.27 -1.84 0.478 0 0.22 -1.29 0.00 0.00 -1.29 1.27 -1.63 0.459 0 0.24 -1.13 0.00 0.00 -1.13 1.27 -1.44 0.43

10 0 0.27 -0.99 0.00 0.00 -0.99 1.27 -1.26 0.4211 0 0.30 -0.86 0.00 0.00 -0.86 1.27 -1.09 0.4012 0 0.32 -0.73 0.00 0.00 -0.73 1.27 -0.93 0.4013 0 0.35 -0.61 0.00 0.00 -0.61 1.27 -0.78 0.3914 0 0.38 -0.50 0.00 0.00 -0.50 1.27 -0.63 0.3815 0 0.41 -0.38 0.00 0.00 -0.38 1.27 -0.48 0.3816 1 0.43 -0.27 -0.27 0.07 -0.27 1.27 -0.34 0.3717 1 0.46 -0.16 -0.16 0.03 -0.16 1.27 -0.21 0.3718 0 0.49 -0.05 0.00 0.00 -0.05 1.27 -0.07 0.3719 0 0.51 0.05 0.00 0.00 0.05 1.27 0.07 0.3720 1 0.54 0.16 0.16 0.03 0.16 1.27 0.21 0.3721 2 0.57 0.27 0.54 0.15 0.27 1.27 0.34 0.3722 2 0.59 0.38 0.77 0.29 0.38 1.27 0.48 0.3823 2 0.62 0.50 0.99 0.49 0.50 1.27 0.63 0.3824 4 0.65 0.61 2.45 1.50 0.61 1.27 0.78 0.3925 5 0.68 0.73 3.67 2.69 0.73 1.27 0.93 0.4026 10 0.70 0.86 8.60 7.40 0.86 1.27 1.09 0.4027 8 0.73 0.99 7.95 7.89 0.99 1.27 1.26 0.4228 14 0.76 1.13 15.89 18.03 1.13 1.27 1.44 0.4329 17 0.78 1.29 21.89 28.20 1.29 1.27 1.63 0.4530 31 0.81 1.46 45.11 65.65 1.46 1.27 1.84 0.4731 12 0.84 1.64 19.71 32.36 1.64 1.27 2.08 0.5032 25 0.86 1.86 46.41 86.15 1.86 1.27 2.35 0.5433 23 0.89 2.11 48.53 102.42 2.11 1.27 2.67 0.6034 5 0.92 2.43 12.14 29.47 2.43 1.27 3.07 0.6835 3 0.95 2.86 8.59 24.58 2.86 1.27 3.62 0.8236 1 0.97 3.58 3.58 12.84 3.58 1.27 4.54 1.14

29

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Table 31

Item Calibration for Connectedness Form B

item name item score

item freq.

prop. corr.

prop. incor.

logit incor.

freq.xlogit

freq.xlogit^2

init. delta

expansion

delta Cal. SE

27 167 1 0.99 0.01 -5.12 -5.12 26.19 -3.24 1.10 -3.58 1.0541 165 1 0.98 0.02 -4.01 -4.01 16.06 -2.13 1.10 -2.35 0.61

36,19 164 2 0.98 0.02 -3.71 -7.43 27.58 -1.84 1.10 -2.03 0.533,26,12 162 3 0.96 0.04 -3.30 -9.89 32.59 -1.42 1.10 -1.57 0.44

15 161 1 0.96 0.04 -3.14 -3.14 9.83 -1.26 1.10 -1.39 0.4129,2 160 2 0.95 0.05 -3.00 -5.99 17.95 -1.12 1.10 -1.24 0.3813 159 1 0.95 0.05 -2.87 -2.87 8.25 -1.00 1.10 -1.10 0.36

9,38,31,24,11

158 5 0.94 0.06 -2.76 -13.80 38.09 -0.89 1.10 -0.98 0.34

32 157 1 0.93 0.07 -2.66 -2.66 7.07 -0.79 1.10 -0.87 0.331 156 1 0.93 0.07 -2.56 -2.56 6.58 -0.69 1.10 -0.76 0.31

39,20 155 2 0.92 0.08 -2.48 -4.96 12.29 -0.61 1.10 -0.67 0.3017 153 1 0.91 0.09 -2.32 -2.32 5.39 -0.45 1.10 -0.50 0.28

22,18,16,14 152 4 0.90 0.10 -2.25 -9.01 20.27 -0.38 1.10 -0.42 0.28

34 151 1 0.90 0.10 -2.18 -2.18 4.77 -0.31 1.10 -0.34 0.2740,4 150 2 0.89 0.11 -2.12 -4.24 8.99 -0.25 1.10 -0.27 0.26

6 149 1 0.89 0.11 -2.06 -2.06 4.24 -0.19 1.10 -0.21 0.265 144 1 0.86 0.14 -1.79 -1.79 3.21 0.08 1.10 0.09 0.23

45 141 1 0.84 0.16 -1.65 -1.65 2.73 0.22 1.10 0.24 0.2221 136 1 0.81 0.19 -1.45 -1.45 2.09 0.43 1.10 0.47 0.21

8,35 132 2 0.79 0.21 -1.30 -2.60 3.38 0.57 1.10 0.63 0.207 129 1 0.77 0.23 -1.20 -1.20 1.43 0.68 1.10 0.75 0.19

10 128 1 0.76 0.24 -1.16 -1.16 1.35 0.71 1.10 0.78 0.1942,37 122 2 0.73 0.27 -0.98 -1.95 1.90 0.90 1.10 0.99 0.18

33 121 1 0.72 0.28 -0.95 -0.95 0.89 0.93 1.10 1.02 0.1823 117 1 0.70 0.30 -0.83 -0.83 0.69 1.04 1.10 1.15 0.1844 109 1 0.65 0.35 -0.61 -0.61 0.38 1.26 1.10 1.39 0.1749 105 1 0.63 0.38 -0.51 -0.51 0.26 1.36 1.10 1.50 0.1725 96 1 0.57 0.43 -0.29 -0.29 0.08 1.59 1.10 1.75 0.16

46,43 73 2 0.43 0.57 0.26 0.53 0.14 2.14 1.10 2.36 0.1630 66 1 0.39 0.61 0.44 0.44 0.19 2.31 1.10 2.55 0.1728 43 1 0.26 0.74 1.07 1.07 1.14 2.94 1.10 3.24 0.1948 28 1 0.17 0.83 1.61 1.61 2.59 3.48 1.10 3.84 0.2247 24 1 0.14 0.86 1.79 1.79 3.21 3.66 1.10 4.04 0.23

Table 32

30

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Nursing Quality Scale

Person Calibration for Connectedness Form B

possible score

person freq.

prop. corr. logit correct

freq.xlogit freq.xlogit^2

init. ability Test width Beta Cal. SE

Exp.Factor

1 0 0.02 -3.87 0.00 0.00 -3.87 1.37 -5.30 1.182 0 0.04 -3.16 0.00 0.00 -3.16 1.37 -4.32 0.843 0 0.06 -2.73 0.00 0.00 -2.73 1.37 -3.74 0.704 0 0.08 -2.42 0.00 0.00 -2.42 1.37 -3.32 0.615 0 0.10 -2.17 0.00 0.00 -2.17 1.37 -2.98 0.556 0 0.12 -1.97 0.00 0.00 -1.97 1.37 -2.70 0.517 0 0.14 -1.79 0.00 0.00 -1.79 1.37 -2.45 0.488 0 0.16 -1.63 0.00 0.00 -1.63 1.37 -2.24 0.459 0 0.18 -1.49 0.00 0.00 -1.49 1.37 -2.04 0.43

10 0 0.20 -1.36 0.00 0.00 -1.36 1.37 -1.86 0.4111 0 0.22 -1.24 0.00 0.00 -1.24 1.37 -1.70 0.4012 0 0.24 -1.13 0.00 0.00 -1.13 1.37 -1.54 0.3913 0 0.27 -1.02 0.00 0.00 -1.02 1.37 -1.40 0.3814 0 0.29 -0.92 0.00 0.00 -0.92 1.37 -1.26 0.3715 0 0.31 -0.82 0.00 0.00 -0.82 1.37 -1.12 0.3616 0 0.33 -0.72 0.00 0.00 -0.72 1.37 -0.99 0.3617 0 0.35 -0.63 0.00 0.00 -0.63 1.37 -0.87 0.3518 0 0.37 -0.54 0.00 0.00 -0.54 1.37 -0.74 0.3519 0 0.39 -0.46 0.00 0.00 -0.46 1.37 -0.63 0.3420 0 0.41 -0.37 0.00 0.00 -0.37 1.37 -0.51 0.3421 0 0.43 -0.29 0.00 0.00 -0.29 1.37 -0.39 0.3422 0 0.45 -0.20 0.00 0.00 -0.20 1.37 -0.28 0.3423 0 0.47 -0.12 0.00 0.00 -0.12 1.37 -0.17 0.3424 1 0.49 -0.04 -0.04 0.00 -0.04 1.37 -0.06 0.3325 1 0.51 0.04 0.04 0.00 0.04 1.37 0.06 0.3326 2 0.53 0.12 0.25 0.03 0.12 1.37 0.17 0.3427 2 0.55 0.20 0.41 0.08 0.20 1.37 0.28 0.3428 1 0.57 0.29 0.29 0.08 0.29 1.37 0.39 0.3429 2 0.59 0.37 0.74 0.28 0.37 1.37 0.51 0.3430 2 0.61 0.46 0.91 0.42 0.46 1.37 0.63 0.3431 3 0.63 0.54 1.63 0.89 0.54 1.37 0.74 0.3532 4 0.65 0.63 2.53 1.60 0.63 1.37 0.87 0.3533 3 0.67 0.72 2.17 1.57 0.72 1.37 0.99 0.3634 5 0.69 0.82 4.09 3.35 0.82 1.37 1.12 0.3635 3 0.71 0.92 2.75 2.52 0.92 1.37 1.26 0.3736 7 0.73 1.02 7.13 7.26 1.02 1.37 1.40 0.3837 6 0.76 1.13 6.76 7.61 1.13 1.37 1.54 0.3938 14 0.78 1.24 17.36 21.52 1.24 1.37 1.70 0.4039 15 0.80 1.36 20.41 27.78 1.36 1.37 1.86 0.4140 12 0.82 1.49 17.90 26.70 1.49 1.37 2.04 0.4341 20 0.84 1.63 32.68 53.41 1.63 1.37 2.24 0.4542 19 0.86 1.79 34.04 61.00 1.79 1.37 2.45 0.4843 19 0.88 1.97 37.42 73.70 1.97 1.37 2.70 0.5144 18 0.90 2.17 39.15 85.13 2.17 1.37 2.98 0.55

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45 7 0.92 2.42 16.94 41.01 2.42 1.37 3.32 0.6146 2 0.94 2.73 5.46 14.91 2.73 1.37 3.74 0.7047 0 0.96 3.16 0.00 0.00 3.16 1.37 4.32 0.8448 0 0.98 3.87 0.00 0.00 3.87 1.37 5.30 1.18

Final Form

The final form of the test is composed of 160 items. There are 40 items for each factor (caring, compassion, commitment, and connectedness). The items that are not significantly different from zero in the Rasch analysis and having high factor loadings are selected to be included in the final form of the NQS test. The content of each item was again reviewed to verify whether each of them are truly composite of the factor they are placed. Table 33 shows the table of specifications of the final form.

Table 33

Table of Specifications for the NQS Final Form

Factors ItemsCaring 5 25 49 63 101 116* 129 153

13 29 53 65 104 117 133 15417 33 57 69 110 121 134 15521 41 60 80 111 125 137 15624 45 61 96 113 127 151 157

Compassion 1 15 39 67 81 88 105 1423* 19 47 71 83 89* 107 1447* 23 51 73 85 91 119 1469 31 55 75 86 99 123 14911 35 59 79 87 103 135 158

Commitment 2 22 42 58 78 102 126 1456 26 43 62 82 106 130 147*10 30 46* 66 90 114 138 15014 34 50 70 94 118 141 15918 38* 54 74 98 122* 143 160

Connectedness 4 27 40 64* 84* 100 120 1368 28 44 68 92* 108 124 139*12 32* 48 72* 93 109 128 14016 36 52 76* 95 112 131 14820 37 56* 77* 97* 115 132 152

* Negative itemsRecommendations for Study

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Based on the initial analysis performed for the NQS test and some encountered procedures that needs to be enhanced, the following recommendations are given:

1. To establish further the reliability of tests, parallel forms of reliability can be conducted. Since the initial form of the test are composed of two forms the scores of each respondent can be correlated to see the consistency of items in a different form that measures the same construct.

2. To establish further the validity of the test, construct validity can be conducted. In the construct validity the scores for each factor can be correlated and theoretically should show positive correlation coefficients.

3. Further studies can be conducted for convergent validation of the test. The Scales of the NQS can be examined with its relationship with different temperament variables like introversion, extraversion, thinking, feeling, sensing, intuiting, and others. The manifestations of each of the factors of the NQS are clearly shown depending on nurse’s temperament.

4. Since the test is part of a battery, the factor on commitment can be related with the cognitive part measuring competency in nursing. Since the content of the items covers academic and skill training it is theoretically related to the outcome of academic skills.

5. Further study can be done using the factor on connectedness. It can be related with communication skills and competency since effectiveness on the factor for connectedness is shown through communication skills.

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