Development and psychometric validation of the hospital Security Personnel Narrative Competency Scale (HSPNCS)

Hospital security personnel frequently interact with patients and families in emotionally complex and potentially conflict-prone situations. However, no specific instrument is available to assess narrative competency in this healthcare support workforce. This study aimed to develop and psychometrically validate the Hospital Security Personnel Narrative Competency Scale (HSPNCS).

A methodological study was conducted to develop and validate the HSPNCS. Scale development followed a theory-driven adaptation approach based on the classical conceptualization of narrative competence and previously validated instruments. The initial item pool was generated through literature review, narrative medicine and medical humanities frameworks, the Nominal Group Technique, content validity assessment, and adaptation to the work context of hospital security personnel. A cross-sectional survey was then conducted among 645 hospital security personnel from 17 hospitals in Zhejiang Province, China. Psychometric evaluation included item analysis, content validity assessment, exploratory factor analysis, confirmatory factor analysis, convergent validity assessment, and internal consistency reliability testing.

The final HSPNCS consisted of 36 items organized into nine first-order subdomains nested within three higher-order dimensions: self-reflection, empathy, and professionalism. The scale demonstrated excellent internal consistency, with a Cronbach's alpha of 0.967 for the total scale and alpha coefficients ranging from 0.911 to 0.945 for the three higher-order dimensions. Content validity was acceptable, with an S-CVI/Ave of 0.972. Factor analyses supported the proposed multidimensional structure, and confirmatory factor analysis indicated acceptable model fit. Composite reliability and average variance extracted values also supported the internal consistency and convergent validity of the scale.

The HSPNCS demonstrated preliminary evidence of content validity, construct validity, convergent validity, and internal consistency among hospital security personnel. It may serve as a useful tool for assessing narrative competency and identifying training needs in this healthcare support workforce. Further studies using independent, multicenter, and culturally diverse samples are needed to confirm its factor structure, test-retest reliability, external validity, and responsiveness to training interventions.