Assessing nurses' digital competence for public health systems: validation of a brief instrument and factors...

Nurses' digital competence and e-health literacy are essential for safe use of electronic health records and other clinical information technologies, yet validated measures and context-specific evidence remain limited. This study evaluated the Polish adaptation of the Digital Competence Questionnaire for Nurses and examined correlates of nurses' perceived digital competence in Poland.

A national cross-sectional computer-assisted web interviewing survey was conducted among practicing nurses (N = 800) in late 2025. The dataset was randomly split for polychoric exploratory factor analysis (N = 367) and confirmatory factor analysis with ordinal diagonally weighted least squares estimation (N = 433). A multiple linear regression model was fitted for the total score in the full sample.

Exploratory analyses indicated one dominant factor; a two-factor benchmark showed limited separability. Confirmatory analysis supported a predominantly unidimensional solution with good approximate fit for the one-factor model (CFI = 0.992; RMSEA = 0.046; SRMR = 0.047); the two-factor benchmark improved fit modestly but the factors were highly correlated (r = 0.885). In regression, higher e-health literacy was strongly associated with higher digital competence [B (SE) = 0.71 (0.05), 95% CI: 0.61 to 0.80]. A higher number of applications used at the workplace was also associated with higher digital competence [B (SE) = 0.22 (0.11), 95% CI: 0.01 to 0.43]. Lower daily internet use (vs > 4 h/day) was associated with lower competence [for <1 h/day: B (SE) = -2.97 (0.61), 95% CI: -4.34 to -1.60], while social media use and most sociodemographic and broad workplace indicators were not independently associated. The model explained 25.9% of variance (R ² = 0.259).

The Polish adaptation of the Digital Competence Questionnaire for Nurses supports use of a concise total score. Digital competence in nurses was most consistently linked to e-health literacy and everyday internet engagement, suggesting that workforce development should combine operational training with skills in information appraisal and safe use of digital resources.