Development of a therapeutic play knowledge scale for pediatric nurses: a methodological study

Abstract

This study aimed to develop the Therapeutic Play Knowledge Scale for Pediatric Nurses and to evaluate its psychometric properties, including content validity, construct validity, and reliability. Method: This methodological, cross-sectional study was conducted with 222 pediatric nurses. The initial item pool was generated through a systematic literature review and expert consultation. Content validity was evaluated by 10 experts using the Item-Level Content Validity Index (I-CVI) and Scale-Level Content Validity Index (S-CVI). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to assess construct validity. Internal consistency was evaluated using Cronbach's alpha and split-half reliability analysis. Results: Content validity indices were high (I-CVI = 0.90–0.99; S-CVI = 0.96). EFA revealed a two-factor structure explaining 68.36% of the total variance. The final version of the scale consisted of 23 items under two subscales: Therapeutic Play Knowledge and Application and Child-Centered Therapeutic Communication. CFA supported the two-factor structure with acceptable model fit indices (χ2/df = 2.83; RMSEA = 0.085; CFI = 0.922; IFI = 0.922; TLI = 0.912). Internal consistency was excellent (Cronbach's alpha = 0.954 and 0.961 for subscales; 0.974 for the total scale). Conclusions: The Therapeutic Play Knowledge Scale for Pediatric Nurses is a valid and reliable instrument with strong psychometric properties. Implications for Nursing Practice: The scale provides a standardized tool to identify knowledge gaps in therapeutic play among pediatric nurses. It can guide the development of targeted educational programs, support evidence-based clinical practice, and contribute to quality improvement initiatives in pediatric care.