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Article

Reliability and Validity of the Korean Version of the Social Justice Scale in Nursing Students

by
Hogi Jung
1 and
Yaki Yang
2,*
1
College of General Education, Woosuk University, Wanju-gun 27841, Korea
2
Department of Nursing, Wonkwang University, Iksan 54538, Korea
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(21), 14443; https://doi.org/10.3390/ijerph192114443
Submission received: 24 September 2022 / Revised: 31 October 2022 / Accepted: 2 November 2022 / Published: 4 November 2022
(This article belongs to the Special Issue Health Management in Person-Centered Care)
Versions Notes

Abstract

:
The purpose of this study was to translate and adapt a scale to evaluate social justice in nursing students and to examine the validity and reliability within a Korean context. With a survey design, a total of 267 nursing students were recruited, and data were collected using a self-administered study questionnaire to measure their levels of SJS. Using SPSS/WIN 28.0, construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale was evaluated. Exploratory factor analysis supported the construct validity with a four-factor solution; that explained 55.52% of the total variance. Criterion validity was demonstrated with the Social Issues Advocacy Scale (r = 0.78, p < 0.001). Cronbach’s α coefficient for the scale was 0.96. The findings show satisfactory construct and criterion validity and reliability of the Korean version of the SJS for measuring social justice in nursing students.

1. Introduction

Social justice is the foundation of public health and refers to academic and professional behaviors that can change the social values, structures, policies, and practices to give socially marginalized groups easier access to resources that can help increase their level of self-determination [1,2]. While it can be viewed as altruistic helping behavior in a broader sense, it can be differentiated from simple helping behavior based on the fact that it includes the concept of social inequality and discrimination due to power relations. Despite increased life expectancy and better health status throughout the world, there is still no improvement in health disparity according to the level of social vulnerability [3]. Health inequity may be determined by various environmental, political, economic, and social conditions that people face. Therefore, helping to give fair and equal access to medical resources, rights, and treatments to groups marginalized within society due to race, age, socioeconomic status, physical ability, and sexual orientation could also be viewed as a form of social justice [4]. Definitions of social justice include the belief that structural or social inequality must be minimized and efforts must be made to strengthen the competencies of the disadvantaged and underprivileged, and thus, practical actions of each individual present important implications for the realization of social justice [5,6].
Social justice has been an issue ever since mankind began to take part in community living. Exploitation and distribution problems emerged as humans formed communities with the division of labor and the creation of classes. Consequently, social justice began to be mentioned in religious scriptures, and after the Roman Catholic Church used the concept of social justice as a core doctrine regarding political, economic, and social poverty or inequalities in the social system, various fields beyond religion began to take an interest in social justice. In nursing, social justice includes the fair distribution of health-related resources, such as clean air, prenatal care, and competent healthcare personnel [7]. Moreover, as an issue and a right in the lives of all members of society and a value ideology pursued by nurses [7,8], it represents a fair social structure and distribution for laying the foundation for human rights and health rights [9]. The Korean Code of Ethics for Nurses clearly states the responsibilities of nursing professionals who embody justice and trust as providing equitable care while advocating human dignity and fundamental rights [10]. Accordingly, nurses have the responsibility to serve to enhance social justice through dynamic and sustained leadership in public and political decision-making for healthcare-related issues [11], while they must also promote social justice through social support for dignified life and death [12] and provide intervention plans for resolving factors that have negative health impact [13].
Social justice is presented not only as a responsibility and requirement for nursing professionals, but it is also depicted as various concepts regarding health equity, fair distribution of medical resources, human rights and health rights, professional competency, nursing practice, and social participation behavior [9,14,15,16]. For nurses, social justice could also include responsibilities and roles as a democratic citizens for resolving social determinants of health; fairly establishing human rights, freedom, and health rights; professional commitment; social participation behavior; and health equity.
Recently, educational institutions for medical and nursing professionals have presented social justice as a core value of healthcare professionals while emphasizing the ethical, moral, and educational obligations to promote social justice expected from professional nursing at national and global levels. The Institute of Medicine proposed values for promoting social justice that nursing organizations, which are at the center of healthcare, should teach to future nurses to enable them to demonstrate leadership when providing high-quality nursing accessible to everyone through the improvement of the healthcare system [17]. The American Association of Colleges of Nursing suggested social justice as a core value in undergraduate nursing education while emphasizing the need for education based on social justice that adheres to moral, legal, and humanistic principles, which must be reflected in professional nursing practice to give equal access to high-quality healthcare services as mandated by law [18,19]. Moreover, the need for a change from the existing nursing curriculum to higher education with the incorporation of social justice was proposed for responding to new demands in nursing education, along with changes in the social environment [20].
Social justice nursing education can prepare nurses to become civic nurses by strengthening the leadership and civic competencies that nursing students need in a healthcare environment so that they may practice social justice to create actual changes in communities and clinical settings [21,22]. For this, measures for integrating core social justice competencies into existing nursing curricula must be explored, while there is the need for a teaching-learning paradigm that can enhance the social justice competencies of nursing students, who are learners, by developing and applying for various social justice nursing education programs. However, despite the importance of education for strengthening social justice competencies in the field of nursing education, there is very little effort to develop social justice as a core competency in the undergraduate curriculum in Korea. There is a need to teach social justice starting from undergraduate courses so that nursing students, who are preparing to become future professional nurses, can use social justice competencies when they practice nursing as professionals in clinical settings [23].
First, a theoretical, conceptual framework for social justice must be established [24,25], and various studies related to social justice in theory and practice must be conducted to enable social justice to develop into a core nursing competency in clinical practice.
To systematically understand and study social justice competencies, a valid and reliable scale that can hold the meaning of competency is needed. This is because having a scale for a certain concept is a fundamental factor that enables quantitative understanding and systematic discussion of that concept. However, an appropriate tool for measuring social justice in nursing students has not been developed in Korea. Accordingly, the present study aimed to accurately measure the level of social justice among nursing students by revising the scale developed by Torres-Harding et al. [6] to reflect the nursing education and clinical setting in Korea. Moreover, the reliability and validity of the scale were tested to further validate the application of this social justice scale.

2. Methods

2.1. Research Design

This methodological study was designed to test the reliability and validity of the Social Justice Scale (SJS) originally developed by Torres-Harding et al. and subsequently revised and updated for Korean nursing students.

2.2. Participants

Participants in the study were students enrolled in the nursing departments of three universities located in G-city and J-Province, and students without clinical practice experience were excluded. In factor analysis, the sample size was calculated as 250 according to the criteria [26] that four times the minimum number of items or a sample number of 200 or more is desirable in consideration of the number of measurement variables, the number of factors, commonality, and factor loading. When considering a 10% withdrawal rate, a total of 280 surveys were distributed, and 270 surveys were collected. A total of 267 surveys were analyzed, excluding three surveys with incomplete responses.

2.3. Ethical Considerations

The author informed the participants of the purpose, procedure, and confidentiality of the study to the participants prior to data collection, and informed consent was obtained from the volunteers. The consent form specified that all personal information obtained will only be used for research purposes and that participants have the freedom to withdraw from the study at any time. This study was approved by the institutional review board (IRB) at W University (IRB No: WKIRB-202105- SB-031).

2.4. Research Instruments

2.4.1. Social Justice

SJS is a tool with proven reliability and validity originally developed by Torres-Harding et al. [6]. This self-reporting scale consists of a total of 24 items in four subscales: social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention. Each item is rated on a 7-point Likert scale (1: strongly disagree, 4: average, and 7: strongly agree), with higher total scores indicating a higher level of social justice. At the time of development, the reliability (Cronbach’s α) of the tool was 0.094, while the reliability of subscales social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention was 0.95, 0.84, 0.82, and 0.88, respectively.

2.4.2. Social Justice Advocacy Scale

The Social Justice Advocacy Scale (SJAS) was used to assess the criterion validity through the correlation with SJS [27]. This scale is suitable for assessing criterion validity because it has predictability for social justice and relatively high reliability and validity, while the content measured by each scale is relatively independent and unique. SJAS defines social justice advocacy as divided into four subscales: political and social advocacy, political awareness, social issue awareness, and confronting discrimination. This scale was developed as a Korean version, and its reliability and validity have been tested [28]. Accordingly, the present study used the Korean version of SJS (K-SJS) to test the criterion validity. At the time of development, the reliability (Cronbach’s α) of the tool was 0.94, while the reliability of subscales political and social advocacy, political awareness, social issue awareness, and confronting discrimination was 0.96, 0.88, 0.97, and 0.91, respectively.

2.5. Scale Development Process

2.5.1. Translation of SJS

In the present study, the validity of the scale translation process was assured by following the recommendations for the translation of scales used when a scale developed in English is applied to a different language and culture [29]. In other words, the items in the final scale were completed by going through the processes of initial translation, expert panel review, back translation, preliminary survey, and cognitive interview.
In the first step, the authors translated the original tool from English to Korean and, interpreted by nursing faculty with expertise in English-to-Korean translation, confirmed that each item was translated faithfully according to the content of the original tool. The translated K-SJS was back-translated to English, without referring to the original English version, by a professor working in nursing who has a Ph.D. in English and is fluent in English and Korean to maintain independence between the original translator and back translator. Subsequently, differences in the choice of words and expressions were reviewed and revised through discussions among the researchers, original translator, and back translator. Only item #13 was revised, and all other items were used without any change to the meaning.

2.5.2. Content Validity Testing

The expert group for verification of content validity consisted of a total of 10 people with more than 5 years of educational experience, 2 professors of nursing management, 2 professors of regional nursing, 2 professors of nursing policy, and 4 professors of the nursing department majoring in tool development. Content relevance was rated on a 4-point Likert scale (1: Not relevant at all, 2: Not relevant; 3: Relevant, and 4: Very relevant). Among scale-level contents validity index (S-CVI), S-CVI/Average value of 0.93–0.97 and cut-off of ≥0.90 [30] were satisfied, and as a result, 24 items comprised the final version of SJS.

2.5.3. Preliminary Survey

In order to increase the content understanding and clarity of the items, a self-reporting questionnaire survey was conducted on 10 nursing students who had not seen the scale before. This preliminary survey was used to check for items that are difficult to understand and to measure the time required to complete the survey using this scale. The preliminary survey results showed that the time required to complete the survey was approximately 10–15 min. Subsequently, the main survey was conducted by completing the final version of the scale by revising words and sentences that were unclear or difficult to understand.

2.5.4. Data Collection

The data used for the analysis conducted in the present study were collected during the period from 18 May 2021 to 13 July 2021. The self-administered questionnaire was used to collect the data. Before the collection of the data, the objective and procedure of the study were explained to the subjects, and the questionnaire was distributed, along with a written consent form and envelope. The written consent forms were sealed in envelopes by the subjects and submitted separately. All the data from the questionnaire were processed anonymously.

2.5.5. Statistical Analysis

The collected data were analyzed using the SPSS Statistics 28.0 program. The participants’ general characteristics were examined using descriptive statistics. For item analysis of the tool, correlation coefficients between individual item scores and total scores were calculated. The verification of the construct validity of the preliminary scale was calculated by exploratory factor analysis. Kaiser-Meyer-Olkin (KMO) values were calculated, and Bartlett’s sphericity was verified to determine the possibility of exploratory factor analysis for verification of construct validity. As an exploratory factor analysis method, the main axis factor extraction method and the Verimax rotation method were used, and the factors were extracted based on the eigen value of 1.00 or higher, and the factor load was applied to the standard >0.40
In order to test the convergent validity and discriminant validity of each item, a multi-traitmulti-item matrix analysis was performed. The criterion validity was analyzed using Pearson’s correlation coefficients. The reliability of the scale was tested based on Cronbach’s α for internal consistency.

3. Results

3.1. General Characteristics of the Study Population

The characteristics of the participants are listed in Table 1. The study population consisted of 258 females (96.6%), including 154 juniors (57.7%). With respect to having a religion, 172 participants (64.4%) responded “No.” With respect to the reason for choosing the major, 135 (50.6%) participants indicated “ease of employment.” With respect to grade point average (GPA) in the previous semester, 78 (29.2%), 119 (44.2%), and 71 (26.6%) participants reported >4.0, 3.5–4.0, and <3.5, respectively. With respect to satisfaction with the major, 171 (64%) participants indicated “satisfied.” With respect to how long they wished to stay in nursing, 123 (46.1%) participants reported “as long as possible,” With respect to experience in social justice-related education, 202 participants (75.7%) indicated “No” (Table 1).

3.2. Item Analysis

The results of item analysis for assessment of items in the scale showed a mean score of 3.85 ± 0.45 points (5-point scale). For the correlation coefficient between individual items and all items, deletion is recommended for those with <0.30 due to low contribution and ≥0.80 due to duplicates [31]. In the present study, the mean correlation coefficient between the initial 24 items and all items was 0.65, with a range of 0.51 to 0.78. Therefore, specific items were not excluded since the items were not <0.30 or ≥0.80.

3.3. Validity Analysis

3.3.1. Construct Validity

KMO and Bartlett’s test of sphericity was performed to determine the sampling adequacy in the factor analysis for testing the construct validity of the scale. The results showed KMO = 0.88 and ×2 = 2885.40 (p < 0.001), and thus, the factor analysis model was determined to be adequate. Principal factor analysis was used for factor extraction, while varimax rotation was used for factor rotation. In the first factor analysis, a total of four factors with Eigen value ≥ 1 was extracted. The final number of items for the scale was determined to be 24. Based on the factor analysis results, the first, second, third, and fourth factors were identified to be social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention, respectively, and each other test factor had an explanatory power of 16.89%, 16.31%, 13.04%, and 9.28%, respectively, with a total cumulative explanatory power of 55.52% (Table 2). When considering the conceptual meaning of the scale, the first, second, third, and fourth factors were named social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention, respectively.

3.3.2. Convergent Validity and Discriminant Validity

The convergent validity of an item is established when the correlation coefficient calculated after controlling the items overlapped with the subscale of each item is ≥0.40. The discriminant validity of an item is established when the correlation coefficient of the subscale that the item belongs to is larger than that of other subscales [32]. In the present study, multi-trait/multi-item matrix analysis was performed to test the convergent and discriminant validity of items (Table 3). The correlation coefficients for items and the subscales to which they belong were all ≥0.40, indicating a scaling success rate of 100% for convergent validity. Moreover, the correlation coefficients of all items for the subscale to which they belong were larger than that of other subscales, indicating a scaling success rate of 100% for discriminant validity.

3.3.3. Criterion Validity

In order to test the criterion validity of the scale, the correlations among the four subscales of SJAS by Lim (28) were investigated (Table 4). The results showed a positive correlation between social justice and social justice advocacy (r = 0.78, p < 0.001). The entire scale for social justice also showed positive correlations with subscales of political and social advocacy (r = 0.68, p < 0.001), political awareness (r = 0.65, p < 0.001), social issue awareness (r = 0.66, p < 0.001), and confronting discrimination (r = 0.50, p < 0.001). Moreover, the subscales of SJS showed positive correlations with the subscales of SJAS.

3.4. Reliability

Internal consistency, as measured with Cronbach’s α, was 0.91, and Cronbach’s α for each subcategory was as follows: social justice attitudes 0.838, perceived behavioral control 0.803, subjective norms 0.808, and behavioral intention 0.835 (Table 2).

4. Discussion

The present study aimed to test the validity and reliability of SJS by Torres-Harding et al. for nursing students in Korea. The study attempted to increase the external validity by recruiting juniors and seniors enrolled in nursing programs at three colleges in J city. As future clinical nurses, nursing students must practice nursing as professionals through social justice competencies in clinical practice [23]. The present study was significant in that it was attempted under the current situation in Korea, where discussions on the moral values and roles of social justice in the field of nursing are lacking.
SJS by Torres-Harding et al. was developed based on the concepts of four factors (social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention) related to social justice with the conceptual framework of the theory of planned behavior by Ajzen. The theory of planned behavior by Ajzen is useful for explaining various human behaviors, and just as the theory of planned behavior assumes, many studies have demonstrated that attitudes, subjective norms, and perceived behavioral control can very accurately predict intention and that intention and perceived behavioral control can explain a significant portion of behavioral changes [33].
In the study, K-SJS for nursing students was developed with 24 items in four subscales of social justice attitudes, perceived behavioral control, subjective norms, and behavioral intention, with each item rated on a 5-point Likert scale.
The first factor, social justice attitudes, consisted of 11 items, and this factor had the highest explanatory power of 16.89% for the social justice of nursing students. Social justice attitudes represent specific beliefs that individuals perceive in relation to the performance of social justice activities. This can be divided into personal (e.g., self-perception and monitoring), interpersonal (e.g., educating other people on social inequality or encouraging people to participate in activities), community (e.g., assessing the special needs of the community or developing community volunteer programs), and institutional/political (e.g., confronting discriminatory policies or practices) dimensions. To practice social justice as nurses, they must be not only aware of the existence of inequality but also be able to recognize that unfair conditions are due to the institutional oppression of certain groups in our society. Moreover, they must also recognize that institutional barriers, policies, and laws influence such injustice and harm. However, they must not focus solely on the disproportionate characteristics of a specific group or a specific individual within a group. In a study by Torres-Harding et al., all four subscales showed high correlations with the public service motivation scale, which suggested that individuals who give positive responses to the items in SJS are likely to show more interest in public service jobs. This is also consistent with the ideals of social justice, reflecting the fact that people who wish to practice social justice may prioritize jobs that serve others [34].
In a study by Arthur et al. [35] on social justice competency and career development, supportive attitudes, respect, empathy, and passionate attitudes for promoting social justice were emphasized as specific attributes needed for career development experts to practice social justice. In other words, actively taking part in the pain of others who emotionally face discrimination and inequality can further strengthen the practice of social justice than cognitively recognizing inequitable situations and understanding the positions of others. Therefore, attitude towards social justice could be an important variable for predicting behavioral intention for social justice. Based on the study that examined changes in social justice attitudes of nursing students after simulation learning on the experience of difficult financial, employment, and parenting situations faced by poor families [36], it is necessary to set the social justice-related program learning outcomes and operate the curriculum for positive cultivation of social justice attitudes among nursing students.
The second factor, perceived behavioral control, had an explanatory power of 16.31%, and it consisted of five items, including items related to self-assessment of how much change is possible or whether the existing situation can be changed. Perceived behavioral control is a major predictor of behavioral intention, and when the behavior itself is especially difficult or challenging, it can directly predict the behavior [33]. Recently, in Korea, the enactment of the Nursing Act has been promoted to ensure patient safety, as well as to secure the work stability and professionalism of nurses, and provide better health and medical services based on collaboration among medical workers. However, due to conflicts of interest among medical groups, it has been in conflict for years and has not been enacted. Heightened perceived behavioral control can directly influence social justice practice. It can also create the expectation that the outcomes of practicing social justice would be positive and promote interest in social justice activities, which can lead to social justice practice.
The third factor, subjective norms, had an explanatory power of 13.04%, and it consisted of five items related to how an individual perceives the patterns of likes, dislikes, and indifferences related to social justice activities of those around him or her. Subjective norms refer to personal perception of what opinion an individual has about specific behaviors of those close to him or her (e.g., friends, family, peers, etc.) [33]. In other words, the thoughts and opinions people close to them, who mutually influence each other, have about specific behavior are a very important and stronger motivation to respond to such opinions, increasing the likelihood of performing such behavior [37]. Miller et al. [38] analyzed the social justice behavior prediction pathway model to confirm that interest in social justice and self-efficacy are direct predictors of social justice practice. Interest and self-efficacy in the social justice behavior prediction pathway model are conceptually similar to subjective norms among the subscales of SJS.
The type of relationship a person forms with another person could influence the way the person perceives a message [39], but the present study did not include other normative factors, such as perception, relationships, broader social context, and media. Therefore, additional studies with the inclusion of other items, such as laws, policies, other social norms, and messages within the surrounding environment that can influence individuals, are needed.
The fourth factor, behavioral intention, had an explanatory power of 9.28%, and it consisted of five items on choices related to social justice activities that the individual planned, agreed on goals, and specific performance. Goals help organize and maintain the long-term behaviors of individuals, even if they are not readily visible, while they also motivate other goals and actions [40]. The model by Ajzen considers intention as a major predictor of behavior, more so than attitudes or subjective norms, which is similar to another study reporting that a positive social justice attitude is a major predictor of behavioral change [41].
The identity of nursing professionals is an important influencing factor in building social justice competency, which is one of the core values of professionals [42], and thus, it is necessary to provide education to improve the identity of professionals starting from the undergraduate curriculum to strengthen social justice competency. In a study on 1610 women, identity as a woman activist was identified as the most powerful predictor of being a feminist or being actually active in gender-related problems [43]. In future studies on nursing students, the correlation between intention to practice social justice and identity as a nursing professional should be investigated, and other variables, such as professional identity, should also be considered for predicting social justice-related behaviors.
The criterion validity of the final scale revised and developed through the present study was tested against SJAS [28]. Criterion validity testing against SJAS showed a highly positive correlation (r = 0.78, p < 0.001). Based on the result, it was determined that the scale developed in the present study is a valid scale for measuring the social justice competencies of nursing students. With respect to correlations by each factor, political and social advocacy and political awareness showed higher correlations with behavioral intention in SJS (0.72 and 0.65, respectively). A high correlation between political and social advocacy and behavioral intention supported the model by Ajzen, which showed that intention was a major predictor of action, more so than attitudes or subjective norms. A high correlation between political awareness and behavioral intention supported the analysis of the social justice behavior prediction pathway model by Miller et al. [38], which confirmed that interest in social justice is a direct predictor of social justice practice.
Reliability test results showed high reliability with Cronbach’s α of 0.91. The reliability of subscales was also high, ranging between 0.80 and 0.84. Therefore, the scale could be valuable when used in actual nursing education.
In a previous study, attitudes, beliefs, knowledge, skills, and behaviors of college students were identified as key concepts that influence social justice-related core competencies [44], and concepts such as perception and advocacy skills were reported to be closely correlated [45]. Moreover, a study on multicultural education for social justice [46] identified behavioral intention as an influencing factor of social justice competency, while a study on social justice nursing education strategy [36] identified attitudes, behaviors, social norms, and critical thinking as very important competencies for social justice practice. The behavioral intention could be viewed as a natural outcome that can be induced by enhancing attitudes, subjective norms, and perceived behavioral control, and thus, educational programs for social justice attitudes, subjective norms, and perceived behavioral control must be specifically designed and accompanying teaching-learning methods and strategies must be prepared to enhance social justice among nursing students.
K-SJS, which was tested for reliability and validity in the present study, was revised by checking the cultural validity of Korea, and it consisted of four subscales for social justice among nursing students. Understanding the cognitive process that leads to each individual participating in social justice-related activities could be helpful in developing educational programs for enhancing social justice competencies and testing the effects of such programs. Moreover, a more accurate assessment and scientific prediction of factors that contribute to social justice could be helpful for establishing measures to promote social justice and develop follow-up action plans.

5. Conclusions

Social justice is an essential practical competency that clinical nurses must have to provide the best possible care to patients. In the present study, the validity and reliability of a scale can measure the social justice competencies of nursing students with consideration of the clinical setting and nursing education situation in Korea. The significance of the present study is that it provides the theoretical evidence for the development of educational and training programs for enhancing social justice by developing a scale that reflects the characteristics of Korea and can identify the attributes of social justice among nursing students when there is a lack of systematic education and measurement tools for social justice of nurses. The scale developed by the present study is expected to be used for education, training, and testing of the effects of relevant interventions for social justice among nursing students and clinical nurses.

6. Limitations

In the preliminary survey, the number of students was 10, and students from other courses were not included.

Author Contributions

Conceptualization, H.J. and Y.Y.; methodology, H.J.; software, H.J.; validation, H.J. and Y.Y.; formal analysis, Y.Y.; investigation, H.J.; resources, Y.Y.; data curation, Y.Y.; writing—original draft preparation, Y.Y.; writing—review and editing, H.J. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of W University (IRB No: WKIRB-202105- SB-031).

Informed Consent Statement

After they agreed to participate, the volunteers signed written informed consent.

Data Availability Statement

After acceptance of this article, data used for data analysis will be made publicly available.

Acknowledgments

The authors thank all study participants and the study personnel for their dedication and continuing support.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Smith, M.J.; Thompson, A.; Upshur, R.E.G. Public health as social justice? A qualitative study of public health policy-makers’ perspectives. Soc. Justice Res. 2019, 32, 384–402. [Google Scholar] [CrossRef]
  2. Goodman, L.A.; Liang, B.; Helms, J.E.; Latta, R.E.; Sparks, E.; Weintraub, S.R. Training counseling psychologists as social justice agents: Feminist and multicultural principles in action. Couns. Psychol. 2004, 32, 793–837. [Google Scholar] [CrossRef]
  3. World Health Organization. The World Health Report 2008: Primary Health Care Now More than Ever; World Health Organization: Geneva, Switzerland, 2008. [Google Scholar]
  4. Constantine, M.G.; Hage, S.M.; Kindaichi, M.M.; Bryant, R.M. Social justice and multicultural issues: Implications for the practice and training of counselors and counseling psychologists. J. Couns. Dev. 2007, 85, 24–29. [Google Scholar] [CrossRef]
  5. Speight, S.L.; Vera, E.M. A social justice agenda ready, or Not? Couns. Psychol. 2004, 32, 109–118. [Google Scholar] [CrossRef]
  6. Torres-Harding, S.; Siers, B.; Olson, B.D. Development and psychometric evaluation of the social justice scale(SJS). Am. J. Community Psychol. 2012, 50, 77–88. [Google Scholar] [CrossRef]
  7. Fahrenwald, N.L.; Taylor, J.Y.; Kneipp, S.M.; Canales, M.K. Academic freedom and academic duty to teach social justice: A perspective and pedagogy for public health nursing faculty. Public Health Nurs. 2007, 24, 190–197. [Google Scholar] [CrossRef]
  8. Valderama-Wallace, C.P. Critical discourse analysis of social justice in nursing’s foundational documents. Public Health Nurs. 2017, 34, 363–369. [Google Scholar] [CrossRef]
  9. Yanicki, S.M.; Kushner, K.E.; Reuter, L. Social inclusion/exclusion as masters of social in Justice: A call for nursing action. Nurs. Inq. 2014, 22, 121–133. [Google Scholar] [CrossRef]
  10. Korean Nurses Association. Korean Nurse Codes of Ethics; Korean Nurses Association: Seoul, Korea, 2014; Available online: http://www.koreanurse.or.kr/about_KNA/ethics.php (accessed on 10 September 2022).
  11. American Nurses Association. Nursing’s Social Policy Statement: The Essence of the Profession, 3rd ed.; American Nurses Association: Silver Spring, MD, USA, 2010. [Google Scholar]
  12. Canadian Nurses Association. Code of Ethics for Registered Nurses; Canadian Nurses Association: Ottawa, ON, Canada, 2008. [Google Scholar]
  13. Murphy, S.; Kochanek, K.D.; Xu, J.; Arias, E. Mortality in the United States, 2014; (NCHS Data Brief No. 229); Centers for Disease Control and Prevention National Center for Health Statistics: Atlanta, GA, USA, 2015.
  14. LeBlanc, R.G. Digital story telling in social justice nursing education. Public Health Nurs. 2017, 34, 395–400. [Google Scholar] [CrossRef]
  15. Mofa, C.; Longo, J. Social justice as a lens for understanding workplace mistreatment. Adv. Nurs. Sci. 2016, 39, 216–223. [Google Scholar] [CrossRef]
  16. Myllykoski, H. Social justice: Who cares? Alta RN 2011, 67, 28–29. [Google Scholar] [PubMed]
  17. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health; National Academies Press: Washington, DC, USA, 2011. [Google Scholar]
  18. American Association of Colleges of Nursing. White Paper on the Education and Role of the Clinical Nurse Leader™; American Association of Colleges of Nursing: Washington, DC, USA, 2011. [Google Scholar]
  19. Paterson, M.A.; Stanley, J.M.; Gaona, N. Public Health: Recommended Baccalaureate Competencies and Curricular Guidelines for Public Health Nursing; American Association of Colleges of Nursing: Washington, DC, USA, 2013. [Google Scholar]
  20. Lozano, R.; Merrill, M.Y.; Sammalisto, K.; Ceulemans, K.; Lozano, F.J. Connecting competences and pedagogical approaches for sustainable development in higher education: A literature review and framework proposal. Sustainability 2017, 9, 1889. [Google Scholar] [CrossRef] [Green Version]
  21. Boutain, D.M. Social justice as a framework for undergraduate community health clinical experiences in the United States. Int. Int. J. Nurs. Educ. Scholarsh. 2008, 5, 1–12. [Google Scholar] [CrossRef]
  22. Clark, K.M.; Miler, J.P.; Leuning, C.; Baumgartner, K. The citizen nurse: An educational innovation for change. J. Nurs. Educ. 2017, 56, 247–250. [Google Scholar] [CrossRef] [PubMed]
  23. Cohen, B.E.; Gregory, D. Community health clinical education in Canada: Part 2—Developing competencies to address social justice, equity, and the social determinants of health. Int. J. Nurs. Educ. Scholarsh. 2009, 6, 1–15. [Google Scholar] [CrossRef] [PubMed]
  24. Grace, P.J.; Willis, D.G. Nursing responsibilities and social justice: An analysis in support of interdisciplinary goals. Nurs. Outlook 2012, 60, 198–207. [Google Scholar] [CrossRef]
  25. Walter, R.R. Emancipatory nursing praxis; A theory of social justice in nursing. Adv. Nurs. Sci. 2017, 40, 223–241. [Google Scholar] [CrossRef]
  26. Coates, C. The evolution of measuring caring: Moving toward construct validity. In Assessing and Measuring Caring in Nursing and Health Science, 2nd ed.; Watson, J., Ed.; Springer: New York, NY, USA, 2009; pp. 297–302. [Google Scholar]
  27. Nilsson, J.E.; Marszalek, J.M.; Linnemeyer, R.M.; Bahner, A.D.; Misialek, L.H. Development and assessment of the social issues advocacy scale. Educ. Psychol. Meas. 2011, 71, 258–275. [Google Scholar] [CrossRef]
  28. Lim, E.M. Validation study of the SIAS(Social Issues Advocacy Scale) for Korean counselors. Korea J. Couns. 2016, 17, 51–70. [Google Scholar] [CrossRef]
  29. Beaton, D.E.; Bombardier, C.; Guillemin, F.; Ferraz, M.B. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000, 25, 3186–3191. [Google Scholar] [CrossRef]
  30. Polit, D.F.; Beck, C.T.; Owen, S.V. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res. Nurs. Health 2007, 30, 459–467. [Google Scholar] [CrossRef] [PubMed]
  31. Field, A.P. Discovering Statistics Using IBM SPSS Statistics, 4th ed.; Sage: London, UK, 2013; p. 952. [Google Scholar]
  32. Fayers, P.M.; Machin, D. Quality of Life: The Assessment, Analysis and Reporting of Patient-Reported Outcomes, 3rd ed.; John Wiley & Sons: Chichester, UK, 2015; p. 648. [Google Scholar]
  33. Ajzen, I. The theory of planned behavior. Organ. Behav. Hum. Decis. Process. 1991, 50, 179–211. [Google Scholar] [CrossRef]
  34. Ngai, S.S. Service-learning, personal development, and social commitment: A case study of university students in Hong Kong. Adolescence 2006, 41, 165–176. [Google Scholar] [PubMed]
  35. Arthur, N.; Collins, S.T.; Marshal, K.; McMahon, M. Social justice competencies and career development practices. Can. J. Couns. Psychother. 2013, 47, 136–154. [Google Scholar]
  36. Einhellig, K.; Gryskiewicz, C.; Hummel, F. Social justice in nursing education: Leap into action. J. Nurs. Care 2016, 5, 374. [Google Scholar] [CrossRef] [Green Version]
  37. Kim, H.S.; Cho, H.I. Gambling behaviors of golf game player: An application of the theory of planned behavior. KJSP 2008, 19, 129–141. [Google Scholar]
  38. Miller, M.J.; Sendrowitz, K.; Conarcher, C.; Blanco, S.; Muniz, P.C.; Bernardi, S.; Morere, L. College students’ social justice interest and commitment: A social-cognitive perspective. J. Couns. Psychol. 2009, 56, 495–507. [Google Scholar] [CrossRef]
  39. Passy, F.; Giugni, M. Social networks and individual perceptions: Explaining differential participation in social movements. Sociol. Forum. 2001, 16, 123–153. [Google Scholar] [CrossRef]
  40. Lent, R.W.; Brown, S.D.; Schmidt, J.; Brenner, B.; Lyons, H.; Treistman, D. Relation of contextual supports and barriers to choice behavior in engineering majors: Test of alternative social cognitive models. J. Couns. Psychol. 2003, 50, 458–465. [Google Scholar] [CrossRef]
  41. Cook, S.W. Toward a psychology of improving justice: Research on extending the equality principle to victims of social injustice. J. Soc. Issues 1990, 46, 147–161. [Google Scholar] [CrossRef]
  42. Costello, A.N. Professional Nursing Values: Accounts of the Witnessed. Bachelor’s Thesis, University of Southern Mississippi, Hattiesburg, MS, USA, 2017. [Google Scholar]
  43. Kelly, C.; Breinlinger, S. Identity and injustice: Exploring women’s participation in collective action. J. Community Appl. Soc. Psychol. 1995, 5, 41–57. [Google Scholar] [CrossRef]
  44. Rats, M.J.; Singh, A.A.; Nassar-McMillan, S.; Butler, S.K.; McCullough, J.R. Multicultural and social justice counseling competencies: Guidelines for the counseling profession. J. Multicult. Couns. Dev. 2016, 5, 28–48. [Google Scholar] [CrossRef]
  45. Motulsky, S.L.; Gere, S.S.; Saleem, R.; Trantham, S.M. Teaching social justice in counseling psychology. Couns. Psychol. 2014, 42, 1058–1083. [Google Scholar] [CrossRef]
  46. Mena, J.A.; Rogers, M.R. Factors associated with multicultural teaching competence: Social justice orientation and multicultural environment. Train. Educ. Prof. Psychol. 2017, 11, 61–68. [Google Scholar] [CrossRef]
Table
Table 1. Demographic Characteristics of Participants (N = 267).
Table 1. Demographic Characteristics of Participants (N = 267).
CharacteristicsCategoriesN(%)
GenderMale9 (3.4)
Female258 (96.6)
School yearJunior154 (57.7)
Senior113 (42.3)
ReligionYes95 (35.6)
No172 (64.4)
Motivation for major selectionAptitude86 (32.2)
Ease of employment135 (50.6)
Suggestion around30 (11.2)
Highschool grade 16 (6.0)
Academic record>4.078 (29.2)
3.5–4.0119 (44.2)
<3.571 (26.6)
Major SatisfactionSatisfied171 (64.0)
Usually88 (33.0)
Unsatisfied8 ( 3.0)
Duration of WorkAs long as possible123 (46.1)
Required time only98 (36.7)
Resign quickly10 (3.7)
Not sure36 (13.5)
Experience of class regarding
Social Justice		Yes65 (24.3)
No202 (75.7)
Table
Table 2. Factor Analysis of Social Justice Scale (N = 267).
Table 2. Factor Analysis of Social Justice Scale (N = 267).
FactorsItemsM ± SD Factor Loading
1234
Social justice:
attitudes		item 5I believe that it is important to help individuals and groups to pursue their chosen goals in life. 4.34 ± 0.650.7990.0730.1110.266
item 9I believe that it is important to support community organizations and institutions that help individuals and groups achieve their aims.4.12 ± 0.700.7800.0100.1000.408
item 10I believe that it is important to promote fair and equitable allocation of bargaining powers, obligations, and resources in our society.4.05 ± 0.790.7540.0550.2470.080
item 6I believe that it is important to promote the physical and emotional well-being of individuals and groups.4.45 ± 0.630.721−0.1340.1740.281
item 4I believe that it is important to try to change larger social conditions that cause individual suffering and impede well-being.4.39 ± 0.660.7030.0400.1090.049
item 7I believe that it is important to respect and appreciate people’s diverse social identities.4.42 ± 0.640.6970.0120.0950.194
item 1I believe that it is important to make sure that al individuals and groups have a chance to speak and be heard, especially those from traditionally ignored or marginalized groups.4.30 ± 0.590.6170.182−0.099−0.007
item 11I believe that it is important to act for social justice.4.08 ± 0.690.5910.2350.0040.357
item 8I believe that it is important to allow others to have meaningful input into decisions affecting their lives.3.73 ± 0.850.5490.0850.2510.070
item 2I believe that it is important to allow individuals and groups to define and describe their problems, experiences, and goals in their own terms.4.12 ± 0.610.5410.1290.0810.172
item 3I believe that it is important to talk to others about societal systems of power, privilege, and oppression. 4.04 ± 0.830.4470.3940.007−0.118
Social justice: perceived behavioral control item 18Other people around me felt that it is important to engage in dialogue around societal injustices.3.38 ± 0.960.0290.7710.2580.190
item 19Other people around me are supportive of efforts that promote social justice.3.47 ± 0.870.2240.7270.1630.327
item 17Other people around me are engaged in activities that address social justice issues.2.93 ± 1.02−0.0960.6960.2680.190
item 20Other people around me are aware of issues of social injustices and power inequalities in our society.3.68 ± 0.860.0000.6930.0780.076
item 14If I chose to do so, I am capable of influencing others to promote fairness and equality.3.57 ± 0.820.1580.7360.1880.150
Social justice: subjective normsitem 16I am certain that if I try, I can have a positive impact on my community3.44 ± 0.840.0650.1980.7130.267
item 13I am certain that I poses an ability to work with individuals and groups in ways that are empowering.3.70 ± 0.820.1880.0810.701−0.005
item 12I am confident that I can have a positive impact on others’ lives.3.65 ± 0.83−0.0030.1560.6780.099
item 15I feel confident in my ability to talk to others about social injustices and the impact of social conditions on health and well-being.3.38 ± 0.890.0200.3880.5540.210
Social justice: behavioral intentionsitem 23In the future, I intend to engage in activities that will promote social justice.3.74 ± 0.850.2070.2320.0770.746
item 2In the future, I will do my best to ensure that all individuals and groups in my community have a chance to speak and be heard.3.76 ± 0.850.2830.2740.2770.665
item 22In the future, I intend to talk with others about social power inequalities, social injustices, and the impact of social forces on health and well-being.3.73 ± 0.880.1330.4640.2040.644
item 2In the future, I intend to work collaboratively with others so that they can define their own problems and build their own capacity to solve problems.3.81 ± 0.770.2640.1260.2450.625
Eigen value7.282.681.581.28
Explained variance (%)16.8916.3113.049.28
Accumulative variance (%)16.8933.2046.2455.52
KMO = 0.88, Bartlett’s test: χ2 = 2885.40 (p < 0.001)
Cronbach’s α0.8380.8030.8080.835
Total Cronbach’s α = 906
Table
Table 3. Multi-trait/Multi-item Matrix Analysis (N = 267).
Table 3. Multi-trait/Multi-item Matrix Analysis (N = 267).
FactorsItemsF1F2F3F42 Standard
Error
rrrr
Social justice: attitudes10.6880.1620.1960.2940.073
20.6440.3050.2140.4180.075
30.5980.2180.3050.3060.101
40.6230.1940.1300.2970.081
50.6910.2680.2110.4460.079
60.6540.2550.0810.3760.077
70.6900.2370.1630.3910.078
80.5900.3790.2310.2690.104
90.5950.3240.2560.4490.085
100.6200.3490.2360.3090.097
110.5910.2600.3440.4460.085
Social justice: perceived behavioral control 120.2310.7250.3010.3490.102
130.3780.7150.2900.3320.100
140.3060.7640.3840.4130.100
150.3640.7370.5240.4420.109
160.3530.7990.4500.4610.103
Social justice: subjective norms170.2490.4640.8210.4270.125
180.2680.4620.8540.4680.117
190.4000.4250.8060.5840.106
200.2170.3140.7050.3470.106
Social justice: behavioral intentions210.5010.4960.4720.8320.103
220.3900.4710.5750.8330.108
230.4760.3510.4260.8200.104
240.4370.4350.3840.7880.095
Table
Table 4. Correlation between K-SJS and Social Justice Advocacy Scale (N = 267).
Table 4. Correlation between K-SJS and Social Justice Advocacy Scale (N = 267).
Social Justice Advocacy Scale
Total①②③④
r (p)
K-SJSTotal0.783 **0.681 **0.651 **0.660 **0.503 **
⑤0.603 **0.456 **0.542 **0.620 **0.413 **
⑥0.561 **0.508 **0.445 **0.448 **0.370 **
⑦0.537 **0.527 **0.411 **0.386 **0.282 **
⑧0.793 **0.721 **0.653 **0.577 **0.525 **
** p < 0.001 ① Political and Social Advocacy ② Political Awareness ③ Social Issue Awareness ④ Confronting Discrimination ⑤ Social justice: attitudes ⑥ Social justice: perceived behavioral control ⑦ Social justice: subjective norms ⑧ Social justice: behavioral intentions.
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Jung, H.; Yang, Y. Reliability and Validity of the Korean Version of the Social Justice Scale in Nursing Students. Int. J. Environ. Res. Public Health 2022, 19, 14443. https://doi.org/10.3390/ijerph192114443

AMA Style

Jung H, Yang Y. Reliability and Validity of the Korean Version of the Social Justice Scale in Nursing Students. International Journal of Environmental Research and Public Health. 2022; 19(21):14443. https://doi.org/10.3390/ijerph192114443

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Jung, Hogi, and Yaki Yang. 2022. "Reliability and Validity of the Korean Version of the Social Justice Scale in Nursing Students" International Journal of Environmental Research and Public Health 19, no. 21: 14443. https://doi.org/10.3390/ijerph192114443

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