Fang Chiu-Shu, Li Cheng-Hsien, Ma Shu-Ching, Hwang Fang-Ming, Martins Maria Manuela, Chou Fan-Hao
Department of Nursing, Chi-Mei Medical Center, Yongkang District, Tainan, Taiwan.
Institute of Human Resource Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
BMC Nurs. 2025 Mar 31;24(1):343. doi: 10.1186/s12912-025-03012-0.
Nurses play an indispensable role in healthcare teams. The quality of nursing care reflects nurses' ability to integrate care and their overall performance in patient care, making it a core objective of clinical nursing. The Chinese version of the Quality of Nursing Care (QNC) scale is a multidimensional assessment tool used for self-evaluation of nursing care quality and holds significant importance in clinical practice. This study aimed to assess the reliability and validity of the Chinese version of the QNC scale among nurses.
This was an observational, cross-sectional, methodological study conducted at three hospitals in southern Taiwan. The 25-item Chinese version of the QNC scale was employed in the study. Data were collected from 944 nurses (response rate: 65.42%) through an online survey conducted between July and August 2022. The factor structure of the QNC scale was evaluated using confirmatory factor analysis (unidimensional, independent cluster model, higher-order, and bifactor) and first-order, higher-order, and bifactor ESEM. Model comparisons were conducted to determine the best-fitting factor structure.
The bifactor ESEM provided the best fit for the QNC scale, consisting of a general QNC factor and seven specific factors: patient satisfaction, health promotion, complication prevention, well-being and self-care, functional readaptation, nursing care organization, and responsibility and rigor. Some items exhibited significant cross-loadings, highlighting the model's ability to capture the multidimensional nature of nursing care quality.
The bifactor ESEM model demonstrated the best model fit for the Chinese version of the QNC scale, offering a reliable and interpretable representation of the multidimensional nature of nursing care. The validated scale provides a valuable tool for assessing nursing care quality in clinical practice.
护士在医疗团队中发挥着不可或缺的作用。护理质量反映了护士整合护理的能力及其在患者护理中的整体表现，使其成为临床护理的核心目标。中文版护理质量（QNC）量表是一种用于护理质量自我评估的多维评估工具，在临床实践中具有重要意义。本研究旨在评估中文版QNC量表在护士中的信效度。
这是一项在台湾南部三家医院进行的观察性、横断面方法学研究。研究采用了25项的中文版QNC量表。通过2022年7月至8月进行的在线调查，从944名护士中收集数据（回复率：65.42%）。使用验证性因子分析（单维、独立聚类模型、高阶和双因子）以及一阶、高阶和双因子ESEM评估QNC量表的因子结构。进行模型比较以确定最佳拟合因子结构。
双因子ESEM对QNC量表的拟合最佳，由一个总体QNC因子和七个特定因子组成：患者满意度、健康促进、并发症预防、幸福感与自我护理、功能再适应、护理组织以及责任与严谨性。一些项目表现出显著地交叉载荷，突出了该模型捕捉护理质量多维性质的能力。
双因子ESEM模型对中文版QNC量表的拟合最佳，为护理质量的多维性质提供了可靠且可解释的表征。经过验证的量表为临床实践中评估护理质量提供了一个有价值的工具。
