We developed a difficulty scale for nurses caring for patients with delirium in the intensive care unit and confirmed its reliability and validity. The difficulty factors were developed with the intention to identify educational interventions for nurses and the introduction of new organisational resources, such as manpower and providing emotional support and feedback to nurses.

Exploratory factor analysis extracted a scale of 33 items with eight factors and an additional scale of four items with one factor.

The analysis of construct validity suggested a possible association with the Strain of Care for Delirium Index.

In the known-group validity, a comparison with two groups based on experience in the intensive care unit found significant differences among the five factors.

Internal consistency (Cronbach’s α = 0.68–.87) and test–retest reliability (intraclass correlation coefficients = .46–.62) were confirmed.

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