Ensuring content validity in instrument development: challenges and innovative approaches.

The challenges of developing new and valid instruments specific for use in nursing research and practice can be complex and varied. In this paper we identify a number of innovative approaches for achieving content validity based on our instrument development work. These approaches include ways of identifying the conceptual domain, the role of literature reviews and key experts, processes used to confirm content validity and clarity of content, feasibility of the validity process and exploration of pertinent ethical issues. The review of key issues covered here may provide guidance for nurses and researchers in developing sound and content valid instruments.