In the nursing system, time is the same care [6]. Time management is the most important part of patient care, so time is also the most important factor in better patient management [7]. In nursing evaluation tools, time management is one of the constructs used to assess clinical nurses competency [11, 12]. The challenge in defining and constructing existing time management tools is to disregard social contexts in organizations. These tools do not address social contexts such as work relationships with colleagues, managers, and customers [13]. Nurses throughout the social process decide how to organize their activities [14]. In the nursing system, time management is a complex concept that neglecting others, the team and the organization and neglecting them will lead to the continuity of individualism and individual time management perspective [15]. ؛ Therefore, given the lack of dedicated tools for assessing the competence of time management based on the social components of clinical nurses, the lack of dedicated tools is tailored to the job characteristics of the clinical nursing community, social processes, and culture influenced by the nursing field.

 

This study was conducted using a sequential heuristic approach [20]. Regarding the neglect of social processes in the existing public time management tools and related to the context of time management competence, a qualitative study was carried out using Grounded Theory. For this purpose, 21 face-to-face interviews were conducted with 21 participants. Strauss and Corbin 2008 version [21] were used to analyze the qualitative data. In the development phase, the four-step model of Waltz et al. (2010) tool construction was used, which included conceptual model selection, measurement goal setting, initial design formulation and measurement tool construction [22]. In the judgment step, quantitative face validity was first assessed by item impact factor using 10 subjects and then qualitative face validity was performed by 5 subjects. In qualitative formal validity, ambiguities and difficulties in understanding words, misinterpretations, difficulty, appropriateness of the item for the purpose of the tool, and in quantitative face validity, the importance of each item or impact factor was retained or eliminated in the target group [23]. [Next, using 5 experts to assess content validity, according to Hynes criteria, content quality validation was first performed [25]. Quantitative content validity was then measured using two methods of content validity ratio (CVR) and content validity index (CVI) using the opinions of 13 nursing instrumentation and management experts.
Finally, exploratory factor analysis was performed for construct validity. Impact coefficients of the items with values ​​higher than 1.5, validity ratio higher than 0.531 and content validity index content higher than 0.79 were the criteria used in this study [26]. Prior to entering the construct validity step, the items were analyzed for their validity. In the exploratory factor analysis stage, sampling was made available. 478 questionnaires were completed for construct validity. In order to analyze the data at the beginning of factor analysis, the appropriate adequacy index was measured in the Kesser, Meier, and Alkin (KMO) samples with a value between zero and one variable [30]. To determine whether the obtained correlation matrix is ​​significantly different from zero and based on it is justifiable factor analysis, the Bartlett Spearman test was used. If the null hypothesis is rejected in this test, the factorization is justified [31]. After this step, factors were extracted. At this point, variables that are highly correlated are grouped into one category or factor. The factor load of each query in the rotated matrix should not be less than 0.3 and preferably higher [32]. In this study, an index of 0.3 was considered. In order to determine the number of factors, the pebble diagram method was used based on Cattell's theory [33-34]. In addition to determining the number of factors based on the pebble diagram, a variance of more than 5% was used to determine the number of tool factors [35]. After extracting the factors of each of them based on the variables (expressions) of each naming factor and the degree of their compatibility with the concepts and dimensions of time management. According to the Three Indicator Rule, at least 3 items were assigned per hidden variable [36]. Convergence with the basic study theory (qualitative step) was also considered in the process of determining the number and naming of factors [37]. Since the assumption of normality was not established in the initial questionnaire data, factor analysis was performed to determine the validity of the original questionnaire based on Factor Principal Axis and the Promax rotation was used assuming correlation of factors. Using 50 subjects, Cronbach's alpha was used to assess internal consistency and test-retest (intra-cluster correlation coefficient) was used to check the consistency of the questionnaire.

A total of 41 quotes from the qualitative step quotes were included in the study. Among these items, 37 items were entered into the item analysis after calculating face validity and content validity indices (CVI = 0.9696). Finally, 36 items entered the exploratory factor analysis process. The Kaiser-Meier-Alkin sampling index was 0.886. Accordingly, appropriate sampling of variables was done based on pairwise correlation and their partial correlation. Also, the null hypothesis of data validity was rejected (P <0.05). Therefore, it was concluded that exploratory factor analysis would provide a suitable model for the present data and that the feasibility and probability factorization were sufficient to predict the factors. At this stage, starting from the factor analysis process, items dropped from 36 to 29 items. These items were grouped into 6 factors: responsibility discipline and norms, professional discipline, emotion management, transfer of experiences, task sharing, and managing the demands of others using the grit diagram method and at least 5% variance criterion. Using the above questionnaire, we can predict 46/714th percentile of total time management changes based on social components of clinical nurses. Cronbach's alpha coefficient and intra-cluster correlation coefficient of the questionnaire were 0.858 and 0.906, respectively.

 

Time management has a dynamic and demanding nature. Clinical nurses save time, prevent time wastage, make better use of time, and potential support resources available through action management and social responses, including adjusting responsibilities and norms, professional discipline, managing emotions, transferring experiences, sharing work and managing requests. Others, in the short or long term, manage their time / tasks and, as appropriate, manage the time / tasks of their colleagues to perform assigned tasks to the nursing team. Since the results of this study were derived from clinical nurses, nursing managers can more confidently use these results to teach time management concepts based on social interactions. This questionnaire can be used to evaluate the competency of clinical nurses' time management in nursing research and clinical nursing system operational units.

 

We are grateful to all the participants for their generous contribution of their views, experiences and time.

 

There is no conflict of interest.