Development and psychometric evaluation of a scale on nursing students’ perceptions of hospital caring environment (PHCE) in China

Abstract

Background: Caring is a basic tenet of nursing and an essential trait a competent nurse. In China, nursing students spend 8-12 months on clinical rotation in hospitals after the completion of theoretical component of the program in their fourth year. The hospital then becomes the focus of nursing clinical education. However, there is no culturally-specific tool to assess nursing students’ perceptions of hospital caring environment (PHCE). The aim of this study was to develop a valid assessment tool to measure nursing students’ perceptions of hospital caring environment. Methods: A two-phase study was conducted to develop a PHCE scale and to test its psychometric properties. In phase one, the items of the PHCE scale were developed from a qualitative study, a literature review and expert validation. The second phase tested the factor structure, construct validity and reliability through a convenience sample of 383 final year nursing students recruited from two teaching hospitals in China (response rate 95.75%). Results: The final PHCE scale consists of 41 items, was internally consistent (Cronbach’s α = 0.98) and had satisfactory test-retest reliability (intra-class correlation coefficient = 0.87). The exploratory factor analysis revealed that the scale contained four subscales, accounting for 63.69% variance. Conclusions: The 41-item NSPHCE is a reliable tool to assess the Chinese nursing students’ perceptions of the hospital caring environment in China.