Readiness Estimate and Deployability Index Revised for Air Force nurses (READI-R-AFN) and READI-R-AFN short form [SF]: Psychometric evaluation

Abstract

Problem. The Air Force (AF) mandates Medical Service maintain readiness for potential deployments. Reineck (1996; 1998) developed, tested and revised the Readiness Estimate and Deployability Index (READI) to assess Army nurses' preparedness for short-notice deployments. Six dimensions of Individual Medical Readiness (IMR) include: Clinical Competency; Operational Competency; Soldier Survival Skills; Personal/Psychosocial/Physical Readiness; Leadership and Administrative Support; and Group Integration and Identification. No instrument was available to assess preparedness of Air Force nurses. Purpose. To evaluate the reliability and validity of the Readiness Estimate and Deployability Index Revised for Air Force Nurses (READI-R-AFN), and from analyses, derive and evaluate the READI-R-AFN Short Form [SF] in a large sample of Air Force nurses. Research questions. What is the reliability of the READI-R-AFN and READI-R-AFN [SF] based on estimates of internal consistency, test-retest reliability, and multiple correlation coefficient (R2)? What is the validity of the READI-R-AFN and READI-R-AFN [SF] based on estimates of confirmatory factor analysis, and convergent-discriminant validity? In the pilot study a convenience sample of 181 active duty AF nurses (52%) responded to the READI-R-AFN; Derogatis Affects Balance Scale (DABS), a measure of emotional well being; and Brief Symptom Inventory-18 (BSI-18), a measure for psychological distress. Methods. Convergent validation evaluated interrelation of items reflecting dimensions of IMR, affects balance, and psychological distress. The READI-R-AFN was refined via preliminary item analysis, internal consistency (alpha coefficient > 0.70), test-retest reliability and structural equation modeling (SEM). Confirmatory factor analysis confirmed the hypothesized nature of the test structure using Flannery's (1994) model of Stress Resistant Persons. Significant items of the 83-item READI-R-AFN were retained for the shorter 40-item form of the READI-R-AFN [SF], subsequently tested for reliability and validity in another convenience sample of 500 active duty AF nurses with 205 nurses responding, (41% response rate). Results. Six dimensions of IMR were confirmed in both samples of active duty AF nurses. Two correlated higher order factors, Skills, resembling Flannery's 'Mastery' domain, and Relationship, resembling Flannery's 'Attachment' domain, accounted for 56% of the variance of the IMR construct. Additional testing of the READI-R-AFN [SF] will further establish construct validity of the measure.