Development and Validation of a Scale for Nurses' Ethical Awareness in The Use of Artificial Intelligence: A Methodological Study

Abstract

The integration of artificial intelligence in nursing practice presents significant ethical challenges that require a comprehensive assessment framework. This study aimed to develop and validate a scale to measure nurses' ethical awareness regarding the use of artificial intelligence in clinical settings. A two-phase methodological approach was employed, involving literature review and interviews for item generation, followed by psychometric evaluation. Data were collected using hand-delivered questionnaires from a convenience sample of 650 nurses. After excluding outliers, 646 responses were randomly split for exploratory and confirmatory factor analyses. An initial pool of 36 items was refined to 21 items across six dimensions: data privacy and confidentiality, consent and autonomy, transparency and accountability, bias and equity, safety and professional integrity, and education and sustainability. Exploratory factor analysis identified a six-factor structure explaining 71.5% of the variance, which was confirmed by confirmatory factor analysis with strong model fit indices. The scale demonstrated excellent reliability (Cronbach's alpha = 0.90) and satisfactory validity. These findings indicate the scale is a reliable and valid tool to assess nurses' ethical awareness in the use of artificial intelligence.

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