Development and psychometric testing of the nurses' core competencies for public health emergencies scale: A multicenter cross-sectional study

Background: The significance of addressing public health emergencies (PHEs) emphasizes the pivotal role of a skilled nursing workforce in effective preparedness and response. However, there's a lack of comprehensive assessments tailored to nurses' core competencies, serving as a standard for ongoing education in preparedness. Objective: This study aimed to develop a psychometrically sound scale for identifying and measuring essential core competencies crucial for nurses during public health emergencies. Design: A multicenter cross-sectional study was conducted. Settings: Twelve tertiary hospitals in Shanghai. Participants: Affiliated nurses with prior experience and significant exposure to public health emergencies were recruited. Methods: The study underwent development and validation in two stages, utilizing qualitative data analysis, a Delphi expert panel, and an empirical quantitative cross-sectional survey. The Nurses' Core Competencies for Public Health Emergencies (NCC-PHEs) scale and a demographic questionnaire were distributed between January 2023 and March 2023. Exploratory factor analysis, confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were employed to identify theoretical constructs, assess scale reliability, and establish validity. Results: Analysis was conducted on valid data collected from 1481 nurses. Factor analysis identified 47 professional nursing competencies arranged within a four-factor high-order model: prevention competencies (9 items), preparation competencies (7 items), response competencies (comprising basic and advanced levels) (26 items), and recovery competencies (5 items). Structural equation modelling confirmed satisfactory factor loadings and a good model fit, validating construct integrity. The reliability of the total scale was confirmed. Conclusion: This study presents a valid scale that empirically measures nurses' core competencies crucial for preparedness and response during public health emergencies. The findings offer instrumental support for guiding the development of future courses and training programs in nursing research and practice.