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Peer-reviewedCC BY 4.0Journal of Nursing Management

Factors Associated With Behavioral Intentions Toward Pain Assessment and Management Among Critical Care Nurses: A Theory‐Based Instrument Validation and Model Testing Study

  • Zhi-Han Cai1,2
  • Tsung-Cheng Hsieh3
  • Li-Hwa Lin4,5
  • Hui-Chun Chung2,6
  • Sophia Huey-Lan Hu1
  • Yi-Shan Hung7
  • Yi-Ching Lin8
  • Mei-Yen Lu9
  • Chia-Hui Li10
  • Ying-Shan Chen11
  • Yuan-Mei Liao12
12 affiliations
  1. 1Department of Nursing College of Nursing National Yang Ming Chiao Tung University Taipei Taiwan nctu.edu.tw
  2. 2Department of Nursing College of Nursing Tzu Chi University Hualien Taiwan tcu.edu.tw
  3. 3Institute of Medical Sciences Tzu Chi University Hualien Taiwan tcu.edu.tw
  4. 4Taipei Municipal Gan-Dau Hospital (Managed By Taipei Veterans General Hospital) Taipei Taiwan
  5. 5Institute of Community Health Care College of Nursing National Yang Ming Chiao Tung University Taipei Taiwan nctu.edu.tw
  6. 6Department of Nursing Hualien Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Hualien Taiwan tzuchi.com.tw
  7. 7Department of Nursing Taichung Tzu Chi General Hospital Taichung Taiwan
  8. 8Department of Nursing Taitung MacKay Memorial Hospital Taitung Taiwan
  9. 9Department of Nursing Hsinchu Mackay Memorial Hospital Hsinchu Taiwan mmh.org.tw
  10. 10Department of Nursing and Department of Surgery Cardinal Tien Hospital New Taipei City Taiwan cth.org.tw
  11. 11Department of Nursing MacKay Memorial Hospital Taipei Taiwan mmh.org.tw
  12. 12Institute of Clinical Nursing College of Nursing National Yang Ming Chiao Tung University Taipei Taiwan nctu.edu.tw
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Abstract

Background: Optimal pain management remains elusive despite the implementation of standard practice guidelines. The theory of planned behavior (TPB) offers a framework for understanding nurses’ clinical practices. Developing and validating theory‐based instruments enables an in‐depth exploration of the sociopsychological factors underlying nurses’ behavioral intentions and practices in pain assessment and management.

Aims: This study aimed to develop and validate the Intention to Perform Pain Assessment and Management Questionnaire (IPPAMQ) and a Behavioral Scale, identify factors associated with nurses’ behavioral intentions, and evaluate the explanatory power of the TPB for nurses’ clinical practices.

Methods: A two‐phase cross‐sectional study was conducted across seven institutions (December 2023–April 2025). Phase I (n = 200) employed a methodological design to establish the psychometric properties of the developed instruments. Phase II (n = 308) utilized the validated instruments to identify factors associated with nurses’ behavioral intentions and to evaluate the TPB’s explanatory power for nurses’ self‐reported practices through path analysis.

Results: Both instruments demonstrated satisfactory psychometric properties. Nurses’ attitudes, subjective norms, and perceived behavioral control were significantly associated with their behavioral intentions, explaining 65% of the total variance, with perceived behavioral control being the strongest correlate. Nurses’ behavioral intentions were significantly associated with self‐reported practices, accounting for 47% of the variance and supporting the TPB’s substantial explanatory power for nurses’ practices.

Conclusions: This study provides psychometrically robust instruments tailored to the TPB framework within the critical care context. The TPB framework effectively highlighted key sociopsychological correlates of nurses’ behavioral intentions and adequately accounted for nurses’ self‐reported pain assessment and management practices.

Implications for Nursing Management: The IPPAMQ enables nurse managers and policymakers to conduct data‐driven evaluations of the sociopsychological factors and identify areas for tailored interventions. The TPB framework’s substantial explanatory power underscores the need for multilevel strategies to narrow the gap between nurses’ behavioral intentions and clinical practices.

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Cite

BibTeXRIS
BibTeX
@article{cai2026factors,
  title = {{Factors Associated With Behavioral Intentions Toward Pain Assessment and Management Among Critical Care Nurses: A Theory‐Based Instrument Validation and Model Testing Study}},
  author = {Zhi-Han Cai and Tsung-Cheng Hsieh and Li-Hwa Lin and Hui-Chun Chung and Sophia Huey-Lan Hu and Yi-Shan Hung and Yi-Ching Lin and Mei-Yen Lu and Chia-Hui Li and Ying-Shan Chen and Yuan-Mei Liao},
  journal = {Journal of Nursing Management},
  year = {2026},
  month = oct,
  doi = {10.1155/jonm/7115245},
  url = {https://doi.org/10.1155/jonm/7115245},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Factors Associated With Behavioral Intentions Toward Pain Assessment and Management Among Critical Care Nurses: A Theory‐Based Instrument Validation and Model Testing Study
AU  - Zhi-Han Cai
AU  - Tsung-Cheng Hsieh
AU  - Li-Hwa Lin
AU  - Hui-Chun Chung
AU  - Sophia Huey-Lan Hu
AU  - Yi-Shan Hung
AU  - Yi-Ching Lin
AU  - Mei-Yen Lu
AU  - Chia-Hui Li
AU  - Ying-Shan Chen
AU  - Yuan-Mei Liao
PY  - 2026
DA  - 2026/10/26
JO  - Journal of Nursing Management
DO  - 10.1155/jonm/7115245
UR  - https://doi.org/10.1155/jonm/7115245
AB  - Background: Optimal pain management remains elusive despite the implementation of standard practice guidelines. The theory of planned behavior (TPB) offers a framework for understanding nurses’ clinical practices. Developing and validating theory‐based instruments enables an in‐depth exploration of the sociopsychological factors underlying nurses’ behavioral intentions and practices in pain assessment and management.  Aims: This study aimed to develop and validate the Intention to Perform Pain Assessment and Management Questionnaire (IPPAMQ) and a Behavioral Scale, identify factors associated with nurses’ behavioral intentions, and evaluate the explanatory power of the TPB for nurses’ clinical practices.  Methods: A two‐phase cross‐sectional study was conducted across seven institutions (December 2023–April 2025). Phase I (n = 200) employed a methodological design to establish the psychometric properties of the developed instruments. Phase II (n = 308) utilized the validated instruments to identify factors associated with nurses’ behavioral intentions and to evaluate the TPB’s explanatory power for nurses’ self‐reported practices through path analysis.  Results: Both instruments demonstrated satisfactory psychometric properties. Nurses’ attitudes, subjective norms, and perceived behavioral control were significantly associated with their behavioral intentions, explaining 65% of the total variance, with perceived behavioral control being the strongest correlate. Nurses’ behavioral intentions were significantly associated with self‐reported practices, accounting for 47% of the variance and supporting the TPB’s substantial explanatory power for nurses’ practices.  Conclusions: This study provides psychometrically robust instruments tailored to the TPB framework within the critical care context. The TPB framework effectively highlighted key sociopsychological correlates of nurses’ behavioral intentions and adequately accounted for nurses’ self‐reported pain assessment and management practices.  Implications for Nursing Management: The IPPAMQ enables nurse managers and policymakers to conduct data‐driven evaluations of the sociopsychological factors and identify areas for tailored interventions. The TPB framework’s substantial explanatory power underscores the need for multilevel strategies to narrow the gap between nurses’ behavioral intentions and clinical practices.
SN  - 0966-0429
SN  - 1365-2834
ER  -