Translation, Reliability and Validity of the Chinese Version of the Confidence in Dementia Scale for Clinical Nursing: A Cross-Sectional Study

Aim

To translate the 9-item Confidence in Dementia (CODE) scale into Chinese (Confidence in Dementia-Chinese, CODE-C) and evaluate its psychometric properties among clinical nurses.

Background

With the rapidly ageing population, an increasing number of patients with dementia will be cared for in hospitals. Clinical nurses' confidence in dementia care is crucial to provide quality care. A reliable and valid assessment tool is urgently needed to measure confidence in dementia and identify educational needs in hospitals. The CODE applies to other societies, and this study aims to standardise this scale for China.

Design

This was a cross-sectional study.

Methods

Following the principles of Brislin bidirectional translation, literal translation, back-translation, expert consultation, cognitive debriefing and preliminary testing were performed, and the CODE-C was preliminarily revised. Internal consistency and test–retest reliabilities with a 2-week interval were tested, and an item analysis was conducted using the Pearson correlation coefficient method. Validity was evaluated, including content, construct, convergent, discriminant and criterion validity.

Results

A total of 452 Chinese-speaking nurses from three hospitals in Jinan, China, completed the survey. The scores of each item and the total score of the CODE-C were positively correlated (r = 0.626–0.802, p < 0.05). The difference between the high-score group and the low-score group for each item of the CODE-C was significant (p < 0.05). The Cronbach's α coefficient, Spearman–Brown coefficient and Guttman split-half coefficient of the CODE-C were 0.894, 0.842 and 0.838, respectively, and the test–retest reliability was 0.892. The scale- and item-level content validity indices were both 1.00. The confirmatory factor analysis model only marginally supported the three-factor structure. Positive correlations were noted between the CODE-C and the General Self-Efficacy Scale (r = 0.476, p < 0.01), suggesting acceptable concurrent validity.

Conclusion

The CODE-C showed acceptable reliability and validity and can be applied to measure the level of confidence in dementia and the outcome of educational interventions aimed at enhancing dementia care among Chinese clinical nurses.

Implications for Practice

The CODE-C can be used as a valid scale to assess the level of confidence in dementia among clinical nurses and help them recognise and improve their level of dementia care.