Developing and validating the Chinese nursing core competence scale for tertiary hospital nurses based on evolving health care needs in China
Meihan Chen, Xiaonan Li, Aiping Wang, Baosen Zhou
Abstract
BACKGROUND: Evolving healthcare paradigms and shifting population health needs necessitate the advancement of nurses' core competencies. Under China's new-era health development strategy, there is an urgent demand to establish a culturally adapted, contemporary competency assessment framework. METHODS: This three-phase study involved: (1) Constructing a preliminary competency framework through systematic literature review and semi-structured interviews; (2) Refining dimensions via two-round Delphi consultations; (3) Validating the Chinese Nursing Core Competence Scale (CNCCS) with data from 1,415 nurses across seven geographical regions (Nov 2022-May 2023), assessing validity through content/structure/criterion-related validation and reliability via internal consistency/test-retest analysis. RESULTS: The Delphi process yielded an 8-dimension, 96-item framework. Exploratory factor analysis retained 62 items across 8 factors explaining 76.106% variance. Confirmatory analysis demonstrated good model fit (χ²/df = 3.376, TLI = 0.924, CFI = 0.929, RMSEA = 0.054, SRMR = 0.078). The scale exhibited acceptable reliability (Cronbach's α = 0.885, ICC = 0.958), meeting psychometric standards. CONCLUSION: The CNCCS comprises 8 dimensions with 62 items, demonstrating robust reliability and validity. Grounded in China's unique healthcare context while addressing global nursing challenges, this instrument provides a scientific foundation for competency evaluation and tiered training programs, offering insights for worldwide nursing competence system development. CLINICAL TRIAL NUMBER: Not applicable.