Development and Validation of An Instrument for Assessing Obstetric Nurses’s Knowledge, Attitude and Practice (KAP) on Prevention of Maternal-To-Child Transmission of Hepatitis B

Background Prevention of mother-to-child transmission (PMTCT) of hepatitis B remains a critical public health issue and a central component of Malaysia’s Triple Elimination Initiative. Obstetric nurses play a pivotal role in implementing PMTCT strategies; however, the absence of psychometrically validated instruments limits the accurate assessment of their knowledge, attitudes and practices (KAP). Objective To develop KAP instrument for PMTCT of hepatitis B among obstetric nurses (SureHepB) and to assess its validity and reliability. Methods A cross-sectional validation study was conducted using a two-phase approach in a tertiary hospital setting. Phase 1 involved questionnaire development, content validation by a multidisciplinary expert panel, and face validation among obstetric nurses. Phase 2 comprised psychometric evaluation using two independent samples for exploratory factor analysis (EFA; n = 207) and confirmatory factor analysis (CFA; n = 203). Results Content validity indices indicated high relevance among expert (S-CVI/Ave = 1.0) and strong inter-rater agreement (Gwet’s AC2 = 0.82). EFA supported a three-factor structure for the attitude and practice domains—Clinical Practice, Professional Responsibilities, and Preventive Awareness—accounting for 75.53% of the total variance. CFA confirmed good model fit (CFI = 0.951, TLI = 0.940, RMSEA = 0.077), with all standardized factor loadings exceeding recommended thresholds. Internal consistency reliability ranged from acceptable to excellent across factors (Cronbach’s α = 0.646–0.920). Conclusion The SureHepB for obstetric nurses is a valid and reliable instrument for assessing PMTCT-related competencies among obstetric nurses, with potential applications in training evaluation, policy planning, and future research.