Development and Validation of the Needle Stick Injury Prevention Beliefs Scale (NSI-PBS) Based on the Health Belief Model (HBM)

Firas S Khraisat,1 Mu’taman Jarrar,2 Marwan Rasmi Issa,3 Mohammad Al-Bsheish,4,5 Jean Hannan,6 Majed M Aljabri,7 Ahmad M Rayani7 1Quality and Patient Safety Administration, King Saud Medical City, Riyadh, Saudi Arabia; 2Department of Community Health Nursing, Princess Aisha Bint Al Hussein College for Nursing and Health Sciences, Al-Hussein Bin Talal University, Ma’an, Jordan; 3Skills Development Training Center, King Saud Medical City, Riyadh, Saudi Arabia; 4Health Management Department, Batterjee Medical College, Jeddah, Saudi Arabia; 5Al-Nadeem Governmental Hospital, Ministry of Health, Amman, Jordan; 6Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA; 7Community and Psychiatric Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Firas S Khraisat, Email [email protected]: Needle stick injuries (NSIs) are among the most frequent and preventable risks to healthcare workers. Behavioral models like the Health Belief Model (HBM) offer valuable insight into preventive behaviors, including those related to NSI. However, no validated tools currently exist to assess NSI-related beliefs using the HBM.Objective: To develop and validate the NSI-Prevention Beliefs Scale (NSI-PBS), a tool grounded in the Health Belief Model (HBM), to examine nurses’ perception about NSI risk and prevention.Methods: The study followed a structured scale development process, including literature review, expert validation, and a cross-sectional survey of 545 nurses was directed in July 2025. Psychometric evaluation involved exploratory and confirmatory factor analysis (EFA/CFA), as well as internal consistency testing, and measurement error assessment.Results: EFA identified a six-factor solution aligned with HBM domains: “Susceptibility, Severity, Benefits, Barriers, Cues to Action, and Self-Efficacy”. CFA confirmed good model fit (CFI =0.926, TLI =0.914, RMSEA =0.063, SRMR =0.058). All subscales demonstrated strong reliability (α =0.81– 0.93; ω =0.82– 0.93). The final version of this scale produced 25 items and showed robust psychometric properties, theoretical coherence, clear factorial structure, and low measurement error.Conclusion: This study contributes to literature by adding a new psychometrically sound and theory-based instrument for assessing NSI prevention beliefs among nurses. The NSI-PBS can be used to measure NSI-Prevention Beliefs in clinical settings and in designing training, risk profiling, and safety interventions for nursing staff and other healthcare workers.Keywords: needle stick injuries, NSI, health belief model, HBM, NSI-prevention beliefs scale, NSI-PBS, psychometrics, scale development, occupational safety