# Psychometric Evaluation of the Integral Nursing Leadership Scale Among Iranian Clinical Nurses: A Methodological Study

## TL;DR

This study evaluates a leadership scale for Iranian nurses, confirming it is reliable and valid for measuring leadership skills in nursing.

## Contribution

The study provides a validated Persian version of the Integral Nursing Leadership Scale for use in Iran.

## Key findings

- The INLS-P showed high internal consistency with a Cronbach's alpha of 0.924.
- Confirmatory factor analysis confirmed the scale's structural validity with factor loadings between 0.48 and 0.91.
- Expert evaluations and ICC scores confirmed strong content and stability validity of the INLS-P.

## Abstract

This study aimed to assess the psychometric characteristics of the Persian version of the Integral Nursing Leadership Scale (INLS-P) within the Iranian clinical nurse population.

As nursing leadership roles gain importance, there is increasing demand for comprehensive leadership approaches addressing modern healthcare challenges. The INLS-P evaluates four critical dimensions: individual leadership qualities (developing personal competencies), individual performance (optimizing work execution), influencing organizational culture (shaping workplace values), and organizational excellence (driving quality outcomes)—all essential for holistic leadership development.

Following COSMIN guidelines, this methodological study was conducted from June to August 2024. A multilevel approach was used: forward–backward translation, face and content validity, construct validity (confirmatory factor analysis), and reliability of the INLS-P were analyzed, respectively.

Our study revealed that the INLS-P demonstrates strong reliability across multiple metrics. Expert evaluations yielded the S-CVI/Ave score of 0.917 regarding content validity. For construct validity, confirmatory factor analysis revealed that the items loaded significantly on their respective factors, with factor loadings ranging from 0.48 to 0.91. Regarding reliability, the overall Cronbach's alpha was 0.924, indicating high internal consistency, while McDonald's omega was 0.931. Coefficient H reached 0.967, further supporting the scale's robustness. Mean interitem correlation averaged 0.427, reflecting solid relationships among items. The intraclass correlation coefficient (ICC) was also 0.917, confirming strong stability across the INLS-P.

The findings indicate that the INLS-P has acceptable face validity, content validity, structural validity, and reliability when used to measure integral leadership qualities, particularly within nursing. This suggests that the INLS-P is a valid and reliable tool for assessing integral leadership skills in nursing.