Development and validation of the nurses' touch comfort evaluation scale in China

Touch comfort refers to the level of comfort nurses feel internally when touching patients. Good touch comfort indicates that nurses feel very comfortable during such interactions. With the steady advancement of the "Healthy China" initiative, there is an increasing demand for humanistic care. Good touch comfort is a critical prerequisite for nurses to complete humanistic care measures efficiently. However, there is currently a lack of effective localized measurement tools to evaluate the touch comfort for Chinese nurses. This study aimed to develop a nurses' touch comfort evaluation scale suitable for Chinese nursing culture and to test its psychometric properties.

The nurses' touch comfort evaluation scale was developed in three stages. In stage 1, a literature review and team discussions were used to create the initial item pool, followed by two rounds of expert consultations and a pre-survey to refine the items and form the initial scale. In Stage 2, a questionnaire survey was conducted with 231 nurses. Item analysis and exploratory factor analysis (EFA) were employed to optimize the items and explore the scale's structure, resulting in a predictive scale. In Stage 3, the performance of the scale was validated with a sample of 355 nurses, leading to the final version of the scale. Confirmatory factor analysis (CFA) and content validity were used to evaluate the scale's validity, while Cronbach's alpha coefficient, split-half reliability, and test-retest reliability were applied to assess its reliability.

The final scale comprises 4 dimensions (treatment task, physiological comfort, individualized assistance, and emotional support) with 35 items, accounting for 76.661% of the cumulative variance. The scale's Cronbach's alpha coefficient, split-half reliability, and test-retest reliability were 0.981, 0.927, and 0.886, respectively. Confirmatory factor analysis results indicated: standardized chi-square statistics(χ2/df) = 3.432, root mean square error of approximation (RMSEA) = 0.083, comparative fit index(CFI) = 0.911, incremental fit index(IFI) = 0.911, Tacker-Lewis index(TLI) = 0.902, parsimonious comparative fit index (PCFI) = 0.830, parsimony normed fit index(PNFI) = 0.801, combined reliability (CR) values ranged from 0.933 to 0.972, average variance extracted (AVE) values ranged from 0.671 to 0.780, and heterotrait-monotrait ratio (HTMT) values ranged from 0.780 to 0.886, indicating good construct validity. Both scale-level and item-level content validity were 1.

The nurses' touch comfort evaluation scale has acceptable reliability and validity, making it an effective tool for assessing the touch comfort of nurses in China.