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Document Type

Thesis - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Barbara Hobbs


The aim of this study was to develop and describe the psychometric properties of an instrument named the Predictors of Safe Handling (PoSH), which was based on theory of planned behavior (TPB) constructs and designed to measure attitudes, subjective norms, perceived control, and intention related to use of patient handling devices. A descriptive test-retest design was used for this study. A convenience sample of 110 licensed (RN and LPN) and unlicensed nurses (CNA, PCA, PCT, and NA) on medical, medical specialty, and intensive care units in three Midwest hospitals completed all of the items in the PoSH instrument. After examining test-retest and internal consistency for reliability and factor analysis to test construct validity, the revised PoSH instrument is shorter and has acceptable estimates of reliability with an overall Cronbach's alpha of 0. 75 for both the test and retest data. Nurses reported positive attitudes related to use of patient handling devices, however use patient handling devices was only reported at 21- 40% of the time with patient who required assistance to move. The mean scores of intention to use safe patient handling devices suggested a greater intention to use the equipment than actual use. Findings revealed that the nurses' subjective norms (the perceived influence of others) and perceived behavioral control scores were close to the midpoint of the range, suggesting that both may be a determinant to address when implementing new safe patient handling practices. The test-retest reliability coefficient was r = 0.82 for the 43 item instrument, which suggested stability of the instrument. After analysis of the constructs using exploratory factor analysis, the refined PoSH instruments was still consistent with the TPB, which indicates that the TPB can be used as an a priori framework to design an instrument to measure use of patient handling devices. The revised PoSH instrument is shorter, and estimates of reliability and validity are acceptable. This study provides investigators and practitioners with a theory-based instrument for measuring the effectiveness of interventions related to the use of patient handling devices.


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