Development and Psychometric Testing of an Instrument to Measure Servant Leadership Behaviors in Magnet Nurse Leaders

ABSTRACT Background Acute care increasingly depends on nursing leaders who demonstrate relational leadership, particularly servant leadership (SL). Evidence links SL to healthy work environments and nurse well‐being. Given its prominence as a core attribute of nurse leadership in Magnet‑designated organizations, a validated instrument to assess SL behaviors is needed; however, no such tool currently exists. Aim To develop and validate an instrument measuring nurse leaders' SL behavior aligned with Magnet's 5 Model Components in hospital settings. Methods Items were generated through literature review and expert evaluation ( n = 16) for content and face validity. In Phase 3, final testing was conducted with nurse leaders from 3 Magnet‑designated U.S. hospitals ( n = 200) completed the scales. Psychometric testing and evaluation were completed. Results Expert review yielded a content validity index of 1.0. Exploratory and confirmatory factor analyses reduced 53 attributes to a 13‑item self‑administered scale aligned with four components. The fifth component, Empirical Outcomes, was embedded within the other four components. Factor loadings ranged from 0.64 to 0.84 (all > 0.30; p < 0.0001). Cronbach's alpha values for all components exceeded 0.85. Findings support the validity, reliability, and multidimensional structure of the Healthcare Servant Leadership Scale (HSLS). Linking Evidence to Practice The HSLS offers a concise, psychometrically robust tool for assessing Magnet's 5 Components in nursing environments. By reducing 53 attributes to 13 items, it enables efficient evaluation of nurse leaders' perceived behaviors and supports evidence‑based leadership development across both Magnet and non‑Magnet hospital settings.