J Nurs Manag. 2018;1–7. wileyonlinelibrary.com/journal/jonm
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1 © 2018 John Wiley & Sons Ltd
1 | INTRODUCTION
Managing the nursing workforce efficiently is a major challenge
for nurse executives and hospital managers because optimal use of
nurses’ time and skills is essential to control costs. Moreover, nurses
working beyond their scope of practice has become a widespread
concern leading to job dissatisfaction, lack of motivation, and work‐
force instability (D’Amour et al., 2012). Nurses working beyond their
scope of practice affects patient outcomes as well as hospital costs
(Bruser & Whittaker, 1998; Déry, D’Amour, Blais, & Clarke, 2015;
Lubbe & Roets, 2014). Accordingly, nurse managers need valid and
reliable information for workforce planning and efficient deploy‐
ment of the nursing workforce.
Despite the importance of the scope of nursing practice, instru‐
ments measuring the scope and complexity of nursing practice are
relatively recent. D’Amour et al. (2012) developed the first Actual
Scope of Nursing Practice (ASCOP) Questionnaire in French and
have published an English version. The questionnaire was developed
Received: 23 August 2017
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Revised: 18 January 2018
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Accepted: 26 February 2018
DOI: 10.1111/jonm.12635
ORIGINAL ARTICLE
The first Arabic version of the Actual Scope of Nursing Practice
Scale: Psychometric evaluation
Souha Fares | Michael Clinton | Lina Younan
Hariri School of Nursing, American
University of Beirut, Beirut, Lebanon
Correspondence
Souha Fares, Hariri School of Nursing,
American University of Beirut, Beirut,
Lebanon.
Email: sf31@aub.edu.lb
Funding information
The study was funded by a seed grant at the
Hariri School of Nursing.
Abstract
Aim: We examined the validity and reliability of nursing activity levels of complexity
in the first Arabic version of the Actual Scope of Nursing Practice Questionnaire.
Background: Nurse executives need valid and reliable data on the scope and com‐
plexity of nursing practice to make decisions about cost‐effective and safe deploy‐
ment of the nursing workforce. We translated the English version of the Actual Scope
of Nursing Practice Questionnaire into Arabic for use in Lebanon and the eastern
Mediterranean region.
Methods: Data were collected from a national sample of bedside nurses in Lebanon
in which 3,157 questionnaires were returned for analysis. We used multidimensional
scaling, hierarchical cluster analysis, and confirmatory factor analysis to examine the
Arabic Actual Scope of Nursing Practice Questionnaire levels of nursing complexity.
Results: Multidimensional scaling analysis and hierarchical cluster analysis confirmed
the unidimensionality of the Arabic Actual Scope of Nursing Practice Questionnaire.
Confirmatory factor analysis produced essentially the same fit statistics for the uni‐
dimensional model and three‐dimensional models of item complexity.
Conclusion: The Arabic Actual Scope of Nursing Practice Questionnaire is a valid and
reliable unidimensional measure of nursing complexity.
Implication for Nursing Management: Nurse executives and hospital managers in
Lebanon and the eastern Mediterranean region can use total and mean Arabic Actual
Scope of Nursing Practice Questionnaire scores as aids when making decisions about
nursing workforce deployment.
KEYWORDS
confirmatory factor analysis, hierarchical cluster analysis, Lebanon, multidimensional scaling,
scope of practice