Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses

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Applied Nursing Research

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The purpose of these studies was to determine the reliability and validity of the 24 item Perspectives on Caring for Older Patients (PCOP) scale and further develop the scale as a useful tool for measuring nurses' perspectives toward caring for older patients.


Ageism has long been an issue in the U.S. as well as globally and is reflected in the attitudes of nurses caring for older patients. Most research in this area utilizes scales that measure attitudes toward older adults or aging in general which is different from how nurses feel about caring for older patients.


Instrument development studies using the PCOP scale were conducted involving two independent samples for exploratory and confirmatory analyses. Study 1 included nurses and nursing students from six hospitals in the U.S. while Study 2 included students in a baccalaureate nursing program. Exploratory factor analysis was conducted in Study 1, and confirmatory factor analysis using structural equation modeling was performed in Study 2. A test of structural invariance was used to confirm stability of factor structure across samples.


Exploratory factor analysis using split samples (Study 1) resulted in a PCOP scale with 12 items, and structural equation modeling confirmed a 9-item factor structure. The test for invariance also showed an excellent fit to the data.


The revised nine-item PCOP scale is a reliable and valid tool for use in measuring nurses' perspectives toward caring for older patients in the U.S. and internationally.