Development and validation of a questionnaire to assess factors affecting the role effectiveness of intravenous therapy specialist nurses in Beijing, China

Despite the growing workforce of intravenous therapy (IV) specialist nurses in China, substantial underutilization remains a significant challenge. The effective use of IV specialist nurses is influenced by a complex interplay of factors. However, no comprehensive instrument currently exists to assess these factors in the Chinese healthcare context systematically. This study aimed to develop and psychometrically test a questionnaire to assess factors affecting the role effectiveness of IV therapy specialist nurses in China. The preliminary questionnaire was developed through literature review, semi-structured interviews, two rounds of expert consultation, and a pilot survey. The final questionnaire was administered to 670 IV therapy specialist nurses from 62 hospitals in Beijing, China, between March and April 2025. Psychometric evaluation included content validity (I-CVI, S-CVI), item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing (Cronbach's α, split-half reliability, test-retest reliability). The final questionnaire consisted of 17 items across two dimensions. The overall Cronbach's α coefficient was 0.969, with split-half reliability of 0.960 and test-retest reliability of 0.990. The scale-level content validity index (S-CVI) was 0.991. EFA extracted two factors explaining 71.047% of the total variance, with factor loadings ranging from 0.643 to 0.924. CFA produced the following fit indices: χ²/df =3.856, RMSEA = 0.092, SRMR =0.0383, GFI =0.860, CFI =0.947, IFI =0.947, NFI =0.930, and RFI =0.918. The average variance extracted (AVE) values for the two factors were 0.707 and 0.724, and composite reliability (CR) values were 0.960 and 0.948. The final model showed improved fit, with most indices meeting recommended thresholds, although RMSEA remained above the recommended cut-off, suggesting that the instrument is a valid and reliable tool for assessing factors affecting the role effectiveness of IV therapy specialist nurses in Beijing, China. Further multicenter studies with larger, more diverse, and independent samples across China are needed to confirm its generalizability, and further refine the instrument for broader application.