Psychometric Evaluation of the Chinese Version of BENEFITS-CCCSAT Based on CTT and IRT: A Cross-Sectional Design Translation and Validation Study.

Chuang Li ¹ Youbei Lin ¹ Betul Tosun ² HongYe Guo ³ Chengrong Ling ⁴ Ran Qi ⁵ Qingyue Luo ⁵ Yan Wang ⁶ Fang Huang ⁷ Jiaqi Wang ¹ ShuHui Ma ¹ DanFeng Xu ⁸ ShuZhen Wu ¹ Lan Zhang ^8*

• ¹ Jinzhou Medical University, Jinzhou, China
• ² Faculty of Nursing, Hacettepe University, Ankara, Ankara, Türkiye
• ³ Shenyang First People’s Hospital, Shenyang Brain Institute, Shenyang, Liaoning Province, China
• ⁴ Second People’s Hospital of Yibin, Yibin, China
• ⁵ Jinzhou Normal College, JinZhou, China
• ⁶ Liaoning University, Shenyang, Liaoning Province, China
• ⁷ Taizhou University, Taizhou, Zhejiang Province, China
• ⁸ First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning Province, China

Background: The importance of culturally competent care in multicultural environments is increasingly recognized, yet effective tools to assess nursing students’ cross-cultural competence remain limited. This study aimed to validate the BENEFITS-CCCSAT scale for Chinese nursing students.Methods: The original BENEFITS-CCCSAT scale 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. Results: CTT analysis showed that the C-BENEFITS-CCCSAT scale had a Cronbach’s α coefficient of 0.80, dimension reliabilities ranging from 0.700 to 0.905, test-retest reliability of 0.881, and a content validity index (S-CVI) of 0.928. The criterion-related validity was 0.619. Confirmatory factor analysis (CFA) indicated good model fit (CMIN/DF = 1.071, RMSEA = 0.08), with factor loadings ≥ 0.50. Rasch analysis showed item reliability of 1, person reliability of 0.76-0.89, item separation index of 17.37-60.34, and person separation index of 1.76-2.89. Infit MNSQ and Outfit MNSQ values for all items ranged from 0.86 to 1.27. Overall, the scale demonstrated good reliability and validity for Chinese nursing students.Conclusion: The 25-item C-BENEFITS-CCCSAT scale 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 generalisability.