Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study

BackgroundThe importance of culturally competent care in multicultural environments is increasingly recognized; however, effective tools to assess nursing students’ cross-cultural competence remain limited. This study aimed to validate the BENEFITS-CCCSAT for Chinese nursing students.MethodsThe orig...

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Main Authors: Chuang Li, Youbei Lin, Betul Tosun, Pin Wang, Hong Ye Guo, Cheng Rong Ling, Ran Qi, Qing Yue Luo, Yan Wang, Fang Huang, Jiaqi Wang, Shu Hui Ma, Dan Feng Xu, Shu Zhen Wu, Lan Zhang
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Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532709/full
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author Chuang Li
Chuang Li
Youbei Lin
Betul Tosun
Pin Wang
Hong Ye Guo
Cheng Rong Ling
Ran Qi
Qing Yue Luo
Yan Wang
Fang Huang
Jiaqi Wang
Shu Hui Ma
Dan Feng Xu
Shu Zhen Wu
Lan Zhang
author_facet Chuang Li
Chuang Li
Youbei Lin
Betul Tosun
Pin Wang
Hong Ye Guo
Cheng Rong Ling
Ran Qi
Qing Yue Luo
Yan Wang
Fang Huang
Jiaqi Wang
Shu Hui Ma
Dan Feng Xu
Shu Zhen Wu
Lan Zhang
author_sort Chuang Li
collection DOAJ
description BackgroundThe importance of culturally competent care in multicultural environments is increasingly recognized; however, effective tools to assess nursing students’ cross-cultural competence remain limited. This study aimed to validate the BENEFITS-CCCSAT for Chinese nursing students.MethodsThe original BENEFITS-CCCSAT was translated, back-translated, culturally adapted, and pre-tested using the Brislin model to form a Chinese version. A combined approach of classical test theory (CTT) and item response theory (IRT) was then used for multidimensional validation.ResultsThe CTT analysis showed that the C-BENEFITS-CCCSAT had a Cronbach’s α coefficient of 0.80, dimension reliability values ranging from 0.700 to 0.905, a test–retest reliability value of 0.881, and a scale-level content validity index (S-CVI) value of 0.928. The criterion-related validity value was 0.619. The confirmatory factor analysis (CFA) indicated a good model fit (CMIN/DF = 1.071, RMSEA = 0.08), with factor loadings ≥0.50. The Rasch analysis showed an item reliability value of 1, person reliability values ranging from 0.76 to 0.89, item separation index values ranging from 17.37 to 60.34, and person separation index values ranging from 1.76 to 2.89. The information-weighted fit statistic mean square (infit MNSQ) and outlier-sensitive fit statistic mean square (outfit MNSQ) values for all items ranged from 0.86 to 1.27. Overall, the scale demonstrated good reliability and validity for the Chinese nursing students.ConclusionThe 25-item C-BENEFITS-CCCSAT demonstrates good reliability and validity and can be applied in educational settings to assess students’ ability to provide culturally competent care. Future studies should test the scale in culturally diverse populations to further determine its applicability and generalizability.
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spelling doaj-art-e66827d4002b4be099df42e5822d038c2025-08-20T02:56:24ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-03-011310.3389/fpubh.2025.15327091532709Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation studyChuang Li0Chuang Li1Youbei Lin2Betul Tosun3Pin Wang4Hong Ye Guo5Cheng Rong Ling6Ran Qi7Qing Yue Luo8Yan Wang9Fang Huang10Jiaqi Wang11Shu Hui Ma12Dan Feng Xu13Shu Zhen Wu14Lan Zhang15First Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaFaculty of Nursing, Hacettepe University, Ankara, TürkiyeFirst Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaThe First People’s Hospital of Shenyang, Shenyang, ChinaDepartment of Nursing, The Second People’s Hospital of Yibin, Yibin, ChinaSchool of Nursing, Jinzhou Normal College, Jinzhou, ChinaSchool of Nursing, Jinzhou Normal College, Jinzhou, ChinaSchool of Nursing, Liaodong University, Dandong, ChinaSchool of Nursing Taizhou University, Taizhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaSchool of Nursing, Jinzhou Medical University, Jinzhou, ChinaFirst Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaBackgroundThe importance of culturally competent care in multicultural environments is increasingly recognized; however, effective tools to assess nursing students’ cross-cultural competence remain limited. This study aimed to validate the BENEFITS-CCCSAT for Chinese nursing students.MethodsThe original BENEFITS-CCCSAT was translated, back-translated, culturally adapted, and pre-tested using the Brislin model to form a Chinese version. A combined approach of classical test theory (CTT) and item response theory (IRT) was then used for multidimensional validation.ResultsThe CTT analysis showed that the C-BENEFITS-CCCSAT had a Cronbach’s α coefficient of 0.80, dimension reliability values ranging from 0.700 to 0.905, a test–retest reliability value of 0.881, and a scale-level content validity index (S-CVI) value of 0.928. The criterion-related validity value was 0.619. The confirmatory factor analysis (CFA) indicated a good model fit (CMIN/DF = 1.071, RMSEA = 0.08), with factor loadings ≥0.50. The Rasch analysis showed an item reliability value of 1, person reliability values ranging from 0.76 to 0.89, item separation index values ranging from 17.37 to 60.34, and person separation index values ranging from 1.76 to 2.89. The information-weighted fit statistic mean square (infit MNSQ) and outlier-sensitive fit statistic mean square (outfit MNSQ) values for all items ranged from 0.86 to 1.27. Overall, the scale demonstrated good reliability and validity for the Chinese nursing students.ConclusionThe 25-item C-BENEFITS-CCCSAT demonstrates good reliability and validity and can be applied in educational settings to assess students’ ability to provide culturally competent care. Future studies should test the scale in culturally diverse populations to further determine its applicability and generalizability.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532709/fullcross-cultural nursingnursing students and educationpsychometrics (MeSH)classical test theoryitem response theory
spellingShingle Chuang Li
Chuang Li
Youbei Lin
Betul Tosun
Pin Wang
Hong Ye Guo
Cheng Rong Ling
Ran Qi
Qing Yue Luo
Yan Wang
Fang Huang
Jiaqi Wang
Shu Hui Ma
Dan Feng Xu
Shu Zhen Wu
Lan Zhang
Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
Frontiers in Public Health
cross-cultural nursing
nursing students and education
psychometrics (MeSH)
classical test theory
item response theory
title Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
title_full Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
title_fullStr Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
title_full_unstemmed Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
title_short Psychometric evaluation of the Chinese version of the BENEFITS-CCCSAT based on CTT and IRT: a cross-sectional design translation and validation study
title_sort psychometric evaluation of the chinese version of the benefits cccsat based on ctt and irt a cross sectional design translation and validation study
topic cross-cultural nursing
nursing students and education
psychometrics (MeSH)
classical test theory
item response theory
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532709/full
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