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Determinants of Nurses' Caring Behaviours: Cultural Adaptation and Psychometric Testing of the Turkish Version-A
Saleh Salimi1, Leman Şenturan2, Nezihe Kizilkaya Beji2
1Nursing Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey.
Background:
Understanding the factors influencing nurses' caring behaviour is imperative for advancing care quality.
Aim:
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.
Method:
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.
Results:
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.
Conclusion:
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.
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