Salimi Saleh, Şenturan Leman, Beji Nezihe Kizilkaya, Mutlu Eren Yaşar
Nursing Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey.
Biruni University, Istanbul, Turkey.
Scand J Caring Sci. 2025 Jun;39(2):e70041. doi: 10.1111/scs.70041.
Understanding the factors influencing nurses' caring behaviour is imperative for advancing care quality.
This study aims to translate and culturally adapt the Determinants of Nurses' Caring Behaviours (DNCB) instrument into Turkish and assess its psychometric properties. The original DNCB consists of 35 items and six subscales, designed to identify and measure the factors that influence nurses' caring behaviours in clinical practice.
This methodological study followed the guidelines for outcome measurement instruments established by COSMIN. The translation process followed the guidelines of the Patient-Reported Outcome (PRO) Consortium, which involved forward and back translation, reconciliation, cognitive interviewing, and expert panel review. A sample of 351 nurses was recruited from adult units at a university-affiliated hospital in Istanbul. Face validity and Content Validity Index (CVI) were assessed by an expert panel. Cronbach's alpha was used to evaluate internal consistency. Construct validity was assessed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), along with model fit evaluations, using SPSS version 25 and AMOS 26.
The EFA revealed that 55% of the total variance was explained by 33 factors. Six distinct factors emerged, labelled as Nurses' Practice and Educational Background, Characteristics of Nurses, Challenge in Nursing Care and Identity, Professional Engagement, Satisfaction with Workplace, and Patient Characteristics. Following refinement, the model demonstrated significant enhancements, with improved indices: Normed Fit Index (NFI) at 0.921, Incremental Fit Index (IFI) at 0.979, and Tucker-Lewis Index (TLI) at 0.951. Additionally, the Comparative Fit Index (CFI) improved to 0.957, with a reduced RMSEA value of 0.053 (90% CI [0.046, 0.055]), indicating a more accurate representation of the data's underlying structure.
The Turkish version of the DNCB demonstrates strong internal consistency and validity, supported by robust psychometric properties. It can serve as an effective instrument for measuring and investigating the determinants of nurses' care behaviour both in Turkey and Northern Cyprus, with implications for nursing practice and future research.
了解影响护士关怀行为的因素对于提高护理质量至关重要。
本研究旨在将《护士关怀行为决定因素》（DNCB）工具翻译成土耳其语并进行文化调适，并评估其心理测量特性。原始的DNCB由35个项目和六个子量表组成，旨在识别和测量影响护士临床实践中关怀行为的因素。
本方法学研究遵循了COSMIN制定的结果测量工具指南。翻译过程遵循患者报告结果（PRO）联盟的指南，包括正向和反向翻译、核对、认知访谈和专家小组审查。从伊斯坦布尔一家大学附属医院的成人科室招募了351名护士作为样本。由专家小组评估表面效度和内容效度指数（CVI）。使用Cronbach's alpha评估内部一致性。使用探索性因素分析（EFA）和验证性因素分析（CFA）以及模型拟合评估来评估结构效度，使用SPSS 25版和AMOS 26。
探索性因素分析表明，33个因素解释了总方差的55%。出现了六个不同的因素，分别标记为护士的实践和教育背景、护士的特征、护理和身份认同方面的挑战、专业投入、对工作场所的满意度以及患者特征。经过优化后，模型显示出显著改进，指标有所改善：规范拟合指数（NFI）为0.921，增量拟合指数（IFI）为0.979，塔克-刘易斯指数（TLI）为0.951。此外，比较拟合指数（CFI）提高到0.957，均方根误差近似值（RMSEA）值降低到0.053（90%置信区间[0.046, 0.055]），表明更准确地反映了数据的潜在结构。
DNCB的土耳其语版本具有很强的内部一致性和效度，得到了稳健的心理测量特性的支持。它可以作为一种有效的工具，用于测量和研究土耳其和北塞浦路斯护士关怀行为的决定因素，对护理实践和未来研究具有启示意义。
