Measurement properties of self-assessment instruments for disaster nursing competencies: a systematic literature review

灾害护理能力自评工具的测量特性:系统性文献综述

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Abstract

BACKGROUND: The ability of nurses to act competently in disasters is increasingly important, considering the rising disaster events. Self-assessment instruments are used for an evaluation of disaster nursing competencies, yet their scientific rigor has not been systematically evaluated. This review aims to identify self-assessment instruments for disaster nursing competencies based on the International Council of Nurses’ framework and to evaluate their psychometric properties to determine a validated gold standard measurement instrument. METHODS: This review was registered in PROSPERO (CRD42024590462). Studies were eligible for inclusion if they involved nurses, used a self-assessment instrument targeting disaster nursing competencies, and reported psychometric evaluations. Exclusion criteria were studies involving other professionals, lacking an all-hazards approach, psychometrics, or using external assessment instruments. A comprehensive search of seven databases (Cochrane Library, MEDLINE, Embase, CINAHL, PsycINFO, SocINDEX, and ERIC) was conducted up to August 2025 and complemented by reference list screening. Risk of bias assessment, evaluation of measurement properties, and evidence synthesis followed the COSMIN guidelines. A modified GRADE system was used to rate the certainty of the evidence. RESULTS: Of 758 screened records, eight studies evaluating eight instruments met the inclusion criteria. All instruments revealed conceptual and methodological limitations. Internal consistency was rated sufficient in all studies: quality of evidence “high”; structural validity and reliability were sufficient in seven studies: quality of evidence “very low” to “high”. Content validity: quality of evidence “very low” to “moderate”, construct validity: quality of evidence “high”, and cross-cultural validity: quality of evidence “very low” were sufficiently demonstrated in two, two, and one study, respectively. Criterion validity, measurement error, and responsiveness were not evaluated in any study. CONCLUSIONS: As no instrument met all the requirements for measurement properties, it was not possible to give an unreserved recommendation. Future work should refine existing tools or develop a new, theory-driven instrument aligned with COSMIN, consistently incorporating the ICN framework and ensuring feasibility, transparency, and accessibility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-025-04236-w.

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