Nurse Education Today 48 (2017) 67–71

Contents lists available at ScienceDirect

Nurse Education Today

journal homepage: www.elsevier.com/nedt

The cross-cultural (transcultural) adaptation and validation of the

nursing image questionnaire
Snjezana Cukljek a,⁎, Vesna Juresa b, Janko Babic a
a
University of Applied Health Sciences, Mlinarska 38, 10 000 Zagreb, Croatia
b
School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia

a r t i c l e i n f o a b s t r a c t

Article history: Education of nurses in the Republic of Croatia is being developed as a result of compliance with education in the
Received 14 March 2016 European Union and the implementation of nursing research that leads to the growth of the whole profession.
Received in revised form 23 August 2016 However, prejudice against the nursing profession is still present and therefore it is necessary to explore the
Accepted 19 September 2016
attitudes of the general population and the population of nurses in the nursing profession in order to discover
Available online xxxx
the causes of such prejudices and act on them. Therefore, the aim of this paper was to present transcultural
Keywords:
adaptation and validation of the Nursing Image Questionnaire, which was created by Toth and associates
Attitude (1998). The questionnaire, which includes 30 items and measures how an individual looks at the roles, values,
Nursing and professional activities of nurses, was conducted as part of a preliminary study and was culturally adapted.
Validation The final study included 905 students who in 2011 and 2012 enrolled in the first year of full-time and part-
Questionnaire time nursing study; the questionnaire was completed by 725 students. Toth and associates assumed that the
attitude toward nursing is expressed as the sum of the responses of all the items, which would mean a factor
structure with high item intercorrelation, but they also split the questionnaire into five thematic units. Results
showed that, contrary to expectations, intercorrelations of items were extremely low and that following the
completion of factor analysis, no satisfactory construct validity was established. From the obtained results, it
can be concluded that it is not justified to create a latent dimension as established by research of Toth and
associates, and the items, although there is a correlation between some of them, should be interpreted and
analysed as independent constructs.
© 2016 Elsevier Ltd. All rights reserved.

1. Introduction
Nursing in the Republic of Croatia is rapidly developing as
a result of changes in education (i.e. the harmonisation of
education in Croatia with the education of nurses in EU countries, ed-
ucation of an increasing number of nurses in higher educational in-
stitutions, education based on theories of nursing care, nurses
making diagnoses and interventions, focus on evidence-based
education, and research in nursing and its application to education
and practice).
Despite the rapid development directed toward professionalisation,
nursing is still struggling with the problems of the public perception of
nursing and presentation of nurses' contributions while providing care
to patients. Still, almost two-thirds of nurses employed in the health
system are nurses with secondary education and a lower competence,
compared to those with bachelors of nursing, which affects the
perception of nursing and work that nurses perform. Research shows
⁎ Corresponding author.
E-mail address: snjezana.cukljek@zvu.hr (S. Cukljek).
that raising the level of education affects the professional status of
nurses (Yazdannik et al., 2012). Positive public perception is extremely
important because public recognition is a crucial component of
professional recognition (Takase et al., 2002). Positive perception of
the nursing profession can result in higher self-confidence, higher job
satisfaction, and higher quality of nursing care. A small amount of
nursing research has been conducted in Croatia aimed at determining
the attitudes of the general population, nurses, other health care
workers, and nursing students toward nursing. Among the general
population, the nursing profession is perceived as heavy and stressed,
underpaid, and not respected (Gavranic et al., 2015). Although the
work of nurses is considered difficult and demanding, there are still
candidates for enrolment into nursing study because of job security,
possibilities of finding jobs in the European Union, and more recently
because of greater advancement opportunities after completing
graduate studies. It is important to gain insight into attitudes toward
nursing in order to, if necessary, affect those attitudes by additional
education to the general population and nurses.
The purpose of this paper is to present cross-cultural adaptation and
validation of the Nursing Image Questionnaire.

http://dx.doi.org/10.1016/j.nedt.2016.09.006
0260-6917/© 2016 Elsevier Ltd. All rights reserved.
68 S. Cukljek et al. / Nurse Education Today 48 (2017) 67–71
1.1. The Cross-Cultural Adaptation
Although in Croatia nursing is rapidly evolving, there is still a small
amount of research nursing instruments developed right here in
Croatia. Nurses in Croatia take on many experiences from the practice
of nurses in Europe and the United States of America, and data from
the literature is adapted to the conditions in nursing in Croatia.
The implementation of the research requires the development of an
instrument or adjustment of the instrument that was previously used
in other studies. Translation and adaptation of the instrument allow
comparison of the results obtained. In conducting the research, it is not
possible to translate and use a questionnaire developed and validated
in another language, because of cultural and language differences. Al-
though the translation and language adaptation is the simplest way to
adapt a questionnaire, this is considered a simple and often insufficient
adaptation of the questionnaire (Maneesriwongul and Dixon, 2004).
Each culture has unique values, organisational systems, and
environment (Beauford et al., 2009). That is why it is necessary when
translating, but before applying, to pay a lot of attention to linguistic
and cultural adaptation of the instrument. The above is particularly
important if we want to compare research results collected on the
basis of the same questionnaire and in different environments. If during
takeover of the questionnaire it is necessary to linguistically and
culturally adapt the questionnaire, then we shall talk about cross-
cultural adaptation. During linguistic adaptation, the questionnaire is
translated; during cultural adaptation, it is adapted for use in a specific
new environment (Beaton et al., 2000; Guillemin et al., 1993).
During transcultural adaptation of the Nursing Image Question-
naire, we were guided by the recommendations for cross-cultural
adaptation from authors Beaton et al. (2000). The recommended
steps are two-way translation, discussion, testing a prefinal version
of the questionnaire on a small group of examinees, cognitive test-
ing, and production of the final version of the questionnaire and ap-
plication. After each stage, it is necessary to draw up a report with a
detailed description of each stage. Some authors state that in multi-
center studies the report should be sent to the author or the main ex-
aminer (Beaton et al., 2007), whereas in cases of smaller research,
this recommendation is not stated (Wild et al., 2005).
The Nursing Image Questionnaire, seventh version (NIQ-7), was
created by Toth et al. (1998) and consists of 30 items that assess
how an individual looks at the roles, values, and professional activities
of nurses. Replies to these items were in the form of a Likert scale,
wherein the points in each item are in the possible range of 1 to 5, de-
pending on the degree of agreement with these statements. The items
that make up the NIQ-7 represent the nursing roles, values, and profes-
sional activities and responsibilities of nurses. The range of the
total number of points ranges from 30 to 150, with higher scores
representing a more positive attitude toward nursing and lower scores
more negative attitude.
Content of the NIQ-7 is based on the content of Hoskins question-
naire, literature review, clinical experience, and the recommendations
from an 11-member panel of experts in medical-surgical nursing,
psychiatric nursing, and maternal-child nursing. Content areas are the
roles of nurses (10 items), values (7 items), social stereotypes toward
nursing (6 items), professionalism (4 items), and the characteristics of
nurses/nursing (3 items) (Toth et al., 1998).
Content validity was confirmed by experts who analysed NIQ-7 twice
to determine the representativeness and relevance of the items. The
back
translation synthesis
translation
Fig. 1. Steps of transcultural adaptation.
construct validity was determined by the method of group differences,
using the results of the 45 examinees who belonged to a group known
to be different in terms of attitudes toward nursing/nurses and 45
examinees of the general population. Examinees in the group known
to be different from the general population, according to the theory of
roles and socialisation, achieved higher scores (t = 6,7; p b 0.001).
The construct validity was also determined by analysing the correlation
of each item with an overall score, and it showed that all the correlations
were between 0.15 and 0.70 (Toth et al., 1998).
Reliability, measured by Cronbach's alpha coefficient, was 0.80 in
a sample of 115 graduated nurses and 0.75 in 388 students in
undergraduate nursing study. Test-retest reliability tested on
students 4 weeks after the first measurement was r = 0.77 (Toth
et al., 1998).
After obtaining approval for the use of the questionnaire by the
author (Toth), translation of the questionnaire was completed. Two
people independently of each other translated the questionnaire
from English into Croatian, a so-called forward-translation. Then
the synthesis of translation and discussion of the applicability and
intelligibility of certain items of the questionnaire was made. Two in-
terpreters translated the final version of the questionnaire back into
English, a so-called back-translation. Then the translations were
compared and aligned, and the prefinal version of the questionnaire
was made. The prefinal version of the questionnaire was completed
by twenty examinees. After completing the questionnaire, the
participants reported on the comprehensiveness and clarity of
items listed in the questionnaire. Since the prefinal version of the
questionnaire was clear, it could have been considered as the final
version of the questionnaire. (See Fig. 1).
When translating the questionnaire, it was necessary to adapt
items 4 and 26. In the original questionnaire, item 4 reads “Nurses
should wear the white uniform in order to be recognized.” In
Croatia, during the 1920s and 1930s of the last century, the standard
nursing uniform was regulated by a light blue uniform, white apron,
and a white cap, and then a dark blue uniform with a white apron
and a white cap (Dugac and Horvat, 2013). Later, in the 1960s and
1970s, the exceptions were nurses in intensive care units and on
the operating block, who wore green uniforms. During the 1990s,
nurses ceased to wear an apron and cap, and in most health institu-
tions they wore a light blue or dark blue uniform. At the beginning
of the 21st century, uniforms in other colours began to be used, but
nurses are still associated with blue uniforms. Therefore, the final
item in adapted translation reads: “Nurses should wear the blue
uniform in order to be identified.”
Direct translation of the item 26 would read: “Nurses who have
completed advanced levels of education significantly contribute to pa-
tient care.” According to the Law on Nursing in the Republic of Croatia,
a basic level of education for nurses is at the secondary school level.
By 2005, education of nurses ended at the bachelor level of study.
Since then, after completing bachelor study, nurses can continue their
studies at specialist professional graduate studies, and since 2010, at
university graduate studies. In order to make this item more clear for
examinees, the translation listed advanced levels of education and in
the questionnaire. Now, the item reads: “Nurses with completed under-
graduate nursing studies and graduate studies significantly contribute
to patient care.” After translation and adaptation, it is necessary to re-
determine the psychometric properties of the questionnaire (Beaton
et al., 2000, 2007).
discussion testing
 S. Cukljek et al. / Nurse Education Today 48 (2017) 67–71 69

2. Methods Table 1
Demographic data on examinees.

2.1. Study Design N %

Type of study Full-time 210 29%

Correlation research has been conducted (i.e. a one-time research): Part-time 515 71%
cross-sectional study design. Gender Female 626 86.3%
Male 77 10.6%
Not stated 22 3.1%
2.2. Examinees
Age 18–22 218 30%
23–29 203 28%
The study included 905 students who in 2011 and 2012 enrolled in 30–39 202 28%
the first year of full-time and part-time nursing study at a higher 40–49 65 9%
education institution in Zagreb, and the questionnaire was completed 50–55 9 1.2%
Not stated 28 3.8%
by 725 students. Full-time nursing study is for students directly after Years of experience (part-time students) 1–5 147 28.5%
graduating from secondary school. Most full-time students have no 6–9 84 16.3%
previous work experience. Part-time nursing study is for candidates 10–19 195 37.9%
who have previously graduated from secondary school for nurses, 20–29 66 12.8%
30–35 7 1.4%
have done an internship and passed the professional exam, and have a
Not stated 16 3.1%
license for independent work as a nurse assistant. Almost all part-time Working place (part-time students) Hospital care 378 73.4%
students work as nurse assistants in addition to and study and other Outpatient care 94 18.3%
work. The research included a greater number of part-time students in Unemployed 12 2.3%
relation to full-time students since a larger number of places for these Not stated 31 6%

students have been announced.

2.3. Data Collection and Instruments
For validation of the questionnaire, nursing students voluntarily
filled out an anonymous questionnaire that included demographic
information and the Nursing Image Questionnaire. Students identified
the following demographic information: age, gender, job title, years of
service, and marital status. The Nursing Image Questionnaire has been
translated and adapted, and includes 30 items on which examinees
answer questions, on the Likert scale of 1 to 5, as to what extent they
agree with each statement on nurses and nursing, where 1 represents
full disagreement and 5 represents full agreement. When scoring, it
was necessary to recode items 4, 9, 15, 17, 19, 23, and 27. In completing
the questionnaire, examinees can score 30 to 150 points. The higher
result achieved on the questionnaire indicates a more positive attitude
toward nursing and a lower result indicates negative attitude.
Examinees completed a questionnaire before the start of the first
lecture related to the field of nursing care.
2.4. Ethical Criteria
The ethics committee of the educational institution in which
research was conducted approved the implementation of the research.
Examinees received verbal explanation of the purpose of the research,
they received a written notice that outlined the purpose of research,
and they signed consent to participate in research. The students
participated in the research voluntarily and anonymously.
3. Results
Data were entered in an Excel spreadsheet and were analysed in
SPSS 17.0 software for statistical analysis. The results showed that the
majority of students who attended the lecture participated in the
research (725/905, 80.1%). Most of the examinees were students of
part-time study (515/725, 71%) and female (86.3%) (Table 1). All part-
time students had worked as a nurse assistant, 44.8% of examinees
had up to 10 years of experience, and the average work experience of
all part-time students was 11.3 years. Most part-time students (73.4%)
were employed in inpatient care.
Table 2 presents the descriptive data of all items of the Nursing
Image Questionnaire. All items were encoded in such a way that a
higher score indicated a more positive attitude toward nursing. The
resulting Cronbach's alpha coefficient of internal consistency was 0.63.
In order to determine the factor structure of the Nursing Image
Questionnaire applied to the population of Croatian students of nursing
and define the areas of measurement, we started the implementation of
factor analysis of the main components.
As one of the preconditions for the implementation of factor analysis
is high interconnection of manifest variables (items), we checked their
intercorrelations. Given that the Kolmogorov-Smirnov test of normal
distribution showed that the distribution of the data of all items
significantly deviated from normal, the Spearman rank correlation
was calculated. Of all the correlation coefficients, including all those
statistically significant, only a small number of them (8) was N0.3.
In order to statistically determine the suitability of the correlation
matrix for the implementation of factor analysis, values of the Bartlett
sphericity test were calculated (3056.138; p b 0.001) and the Kaiser-
Meyer-Olkin (KMO) measures the adequacy (0.784) (Table 3).
Therefore, despite these shortcomings, exploratory factor analysis of
main components has been conducted with varimax rotation and
Kaiser-Guttman criterion of maintaining the main factors. A factor
structure with nine major components was the result that explains
51.86% of the total variance of manifest variables. After the finished
rotation, factors were obtained that were non- interpretable given the
assumed existence of five factors (the role of nurses, values, social
stereotypes toward nursing, professionalism, and characteristic of
nurses/nursing). Even after the ejection of items that had a low
saturation (b0.4), interpretable factor structure was not achieved on
all factors, so we initiated confirmatory factor analysis.
As mentioned above, Toth and associates assumed the existence of
five factors, so this was the number of factors that was preset in the
implementation of the factor analysis. Analysis of the main components
with varimax rotation was conducted once again. Five retained factors
explained 36% of the total variance. From 30 manifest variables, 7 did
not have minimal saturation of 0.4 with any factor.
A model with a simple, clean, and interpretable factor structure by
the implementation of several variants of factor analysis failed to be
obtained.
4. Discussion
The aim of this study was cross-cultural (transcultural) adaptation
and validation of the Nursing Image Questionnaire. During cross-
cultural adaptation, the recommendations of the transcultural
adaptation of authors Beaton et al. (2007) were taken into account.
The recommended steps were applied: two-way translation, discussion,
testing of the prefinal version of the questionnaire on a small group of
70 S. Cukljek et al. / Nurse Education Today 48 (2017) 67–71

Table 2
Descriptive data of items in the nursing image questionnaire.

N M SD MOD MIN MAX

Nurses are patients' advocates. 720 3.92 0.878 4 1 5

Nurses protect patients in the health care system. 722 3.94 0.86 4 1 5
Nurses participate in the development of health care policies. 707 3.17 1.109 4 1 5
Nurses should wear the blue uniform in order to be identified.* 720 2.16 1.157 2 1 5
Nurses act as resource persons for individuals with health problems. 720 4.51 0.631 5 1 5
Nurses in general are kind, compassionate human beings. 724 3.68 0.96 3 1 5
It takes intelligence to be a nurse. 723 3.83 0.976 4 1 5
The services given by nurses is as important as that given by physicians. 725 4.54 0.76 5 1 5
Everyone would benefit if nurses spent less time in school and more time caring for patients.* 723 3.11 1.181 3 1 5
Nurses integrate health teaching into their practice. 721 4.27 0.732 4 1 5
Research is vital to nursing as a profession. 724 4.08 0.813 4 1 5
Nurses are politically active. 720 2.44 0.931 3 1 5
Nurses are capable of independent practice. 722 4.22 0.852 4 1 5
Nurses speak out against inadequate working conditions. 720 3.16 1.191 3 1 5
Nurses are compensated sufficiently for their work by the knowledge that they are helping people.* 722 3.68 1.097 4 1 5
Nurses should have a right to strike. 724 4.09 1.024 5 1 5
Nurses follow the physicians' orders without questions.* 724 3.19 1.115 4 1 5
Men make good nurses. 724 3.99 0.87 4 1 5
Many nurses who seek advanced degrees in nursing would really rather be physicians.* 725 3.37 1.07 3 1 5
Nursing is exciting. 724 3.88 0.914 4 1 5
Nurses incorporate research findings in their clinical practice. 721 3.63 0.827 3 1 5
The major goal of nursing research is to improve patient care. 725 4.15 0.798 4 1 5
Nurses are adequately paid for the work they do.* 725 4.15 0.896 4 1 5
Nurses value time at the bedside caring for patients. 723 3.52 0.907 3 1 5
Nurses should have a baccalaureate degree for entrance into practice. 725 3.20 1.074 4 1 5
Nurses with completed undergraduate nursing studies and graduate studies significantly contribute to patient care. 725 3.85 1.05 5 1 5
One advantage to being a nurse is to marry a physician. * 724 4.43 1.046 5 1 5
Nursing is a respected profession. 722 2.86 1.228 4 1 5
Nurses consistently update their practices in relation to current health trends. 725 3.58 0.977 3 1 5
Nurses feel good about what they do. 725 3.15 0.934 3 1 5

Cronbach Alpha = 0.63 *Recoded item.

examinees, cognitive testing, and production of the final version of the
questionnaire and application.
When translating the questionnaire, it was necessary to adapt items
4 and 26 due to cultural differences. In the original questionnaire devel-
oped by Toth and associates, a white colour of nursing uniform is stated.
Since in Croatia the traditional nursing uniform is blue, after translation
and adaptation the item reads: “Nurses should wear the blue uniform in
order to be identified.” Traditionally, a white uniform is worn by doc-
tors, and the absence of cultural adaptation here would change the
meaning of the item so it could be seen as a change in the status of
nurses to a higher level through change of uniform colour.
According to the Law on Nursing, a basic level of education for nurses
in Croatia is secondary school level. Since 2005, after finishing the
bachelor level of education, students may continue in graduate studies.
In order to emphasise more clearly the advanced education levels in
translating item 26, advanced education levels were additionally
specified, so after translating the item reads: “Nurses with completed
undergraduate nursing studies and graduate studies significantly
contribute to patient care.”
After translation and adaptation, it was necessary to re-determine
the psychometric properties of the questionnaire (Beaton et al., 2000,
2007).
From the results, we can see that the reliability calculated on the
entire scale using a Cronbach's alpha coefficient of internal consistency
is, for the questionnaire with 30 items, relatively low at 0.63, which is
lower than during the validation of the original questionnaire of Toth
et al. (1998), whose reliability ranged from 0.75 to 0.80. Although
Table 3
KMO adequacy measure and Bartlett's test of sphericity.
Kaiser-Meyer-Olkin adequacy measure
Bartlett's test of sphericity Estimated Hi(Beaton et al., 2007)
df
⁎ p b 0.001.
Toth et al. assumed that the attitude toward nursing is expressed as
the sum of the responses of all the items, which would mean the factor
structure with a high intercorrelation of items, they also divided a
questionnaire into five thematic units (the role of nurses [10 items],
values [7 items], social stereotypes toward nursing [6 items], profes-
sionalism [4 items], and the characteristics of nurses/nursing [3 items]).
Contrary to expectations, intercorrelation of items has proved to be
extremely low. Unexpectedly low intercorrelations may be due to the
homogeneity of the sample, leading to low variability and low variance.
According to Tabachnick and Fidell (2001); according to Beavers et al.,
2013), only correlations N0.3 contain enough common variances that
would justify the implementation of factor analysis and identification
of latent variables. However, one of the criteria by which one can
judge whether the correlation matrix is suitable for the implementation
of factor analysis and computation of the Bartlett sphericity test and the
Kaiser-Meyer-Olkin measure of adequacy.
Bartlett's sphericity test evaluates the differences of observed
correlation matrix from the identity matrix (no correlation between
the items). The obtained results show that the values of the Bartlett
test are statistically significant, indicating that the correlation matrix,
despite low correlations, is suitable for factoring. Kaiser-Meyer-Olkin
measures the degree to which the items share a common variance.
The value of 0.784 indicates a medium to high level of adequacy of the
correlation matrix for the implementation of factor analysis.
Therefore, despite these shortcomings, exploratory and confirmato-
ry factor analysis of main components was conducted. Items that mea-
sure stereotypes of nursing were most scattered by factors, which may
be related to a different perception of stereotypes with regard to the cul-
tural environment and the sample of examinees. In subsequent analysis
of the intercorrelation matrix, one can see that no item that measures
attitude toward stereotypes is affiliated with any other item N0.25,
0.784
and most have a correlation b 0.2. If the significance of a particular
3056.138⁎ correlation is attributed to a large sample, one can conclude that these
435 were largely independent variables, whereas the existence of latent
dimensions would assume high interdependence of these items.
 S. Cukljek et al. / Nurse Education Today 48 (2017) 67–71
The main disadvantage and limitation of the conducted research
(i.e. the process of transcultural validation of NIQ-7 developed by Toth
and associates) was the already stated homogeneity of the sample
(only nurses), which leads to a small variability of results and thus
could lead to the inability to confirm the structural validity of the mea-
suring instrument. Re-implementation on a heterogeneous sample of
the general population is recommended in order to determine whether
manifest variables can detect and create the latent structure or if the
measuring instrument can be used and analysed only as a set of
mutually independent variables that measure various aspects of
attitudes toward nursing profession.
5. Conclusions
The cross-cultural adaptation and translation of the NIQ-7 (Toth
et al., 1998) was successfully carried out in accordance with recommen-
dations for transcultural adaptation (Beaton et al., 2000). During
translation, it is important to pay attention to the need for cultural
adaptation of the questionnaire with regard to the specifics of the
environment in which research is planned. In our research, two items
of the questionnaire were adapted. After cultural adaptation, validations
of the questionnaire and factor analysis were performed. After factor
analysis was conducted, satisfactory construct validity has not been
established, and from the results it can be concluded that it is not
justified to create a latent dimensions established by research of Toth
et al. (1998). Although there is a relationship between some of the
items, they should be interpreted and analysed as independent
constructs. In addition, based on the results analysis, validity of express-
ing the overall result as the sum of all items is questionable whereby the
higher score should indicate a positive attitude toward nursing.
71
Acknowledgments
The authors would like to thank the organization and participants
involved in the research.
References
Beaton, D., Bombardier, C., Guillemin, F., Bosi Fearraz, M., 2007. Recommendations for the
Cross-Cultural Adaptation of the DASH & QuickDASH Outcome Measures. Institute for
Work & Health.
Beaton, D., Bombardier, C., Guillemin, F., Bosi Ferraz, M., 2000. Guidelines for the process
of cross-cultural adaptation of self-report measures. Spine 25 (24), 3186–3191.
Beauford, J.E., Nagashima, Y., Wu, M.H., 2009. Using translated instruments in research.
J. Coll. Teach. Learn. 6 (5), 77–81.
Beavers, A.S., Lounsbury, J.W., Richards, J.K., Huck, S.W., Skolits, G.J., Esquivel, S.L., 2013.
Practical considerations for using exploratory factor analysis in educational research.
Pract. Assess. Res. Eval. 18 (6).
Dugac, Z., Horvat, K., 2013. Formal, functional and fashionable: nurse uniforms in Croatia
between the 1920s and 1940s. Acta Med. Hist. Adriat. 11 (2), 251–274 (in Croatian).
Gavranic, D., Iveta, V., Sindik, J., 2015. Perception of the nurse profession in general pop-
ulation. Nurs. J. 20, 115–120 (in Croatian).
Guillemin, F., Bombardier, C., Beaton, D., 1993. Cross-cultural adaptation of health related
quality of life measures: literature review and proposed guidelines. J. Clin. Epidemiol.
46 (12), 1417–1432.
Maneesriwongul, W., Dixon, J.K., 2004. Instrument translation process: a methods review.
J. Adv. Nurs. 48 (2), 175–186.
Tabachnick, B., Fidell, L., 2001. Using multivariate statistics. Needham Heights: Allyn & Bacon.
Takase, M., Kershaw, E., Burt, L., 2002. Does public image of nurses matter? J. Prof. Nurs.
18 (4), 196–205.
Toth, J.C., Dobratz, M.A., Boni, M.S., 1998. Attitude toward nursing of students earning a
second degree and traditional baccalaureate students: are they different? Nurs. Out-
look 46 (6), 273–278.
Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., Erikson, P.,
2005. Principles of good practice for the translation and cultural adaptation process
for patient-reported outcomes (PRO) measures: reports of the ISPOR task force for
translation and cultural adaptation. Value Health 8 (2), 94–104.
Yazdannik, A., Yekta, Z.P., Soltani, A., 2012. Nursing professional identity: an infant or one
with Alzheimer. Iran. J. Nurs. Midwifery Res. 17 (2), 178–186.