| Objective To translate the English version of Holistic Clinical Assessment Tool(HCAT)into Chinese,and test the reliability and validity of the Chinese version of Holistic Clinical Assessment Tool(C-HCAT)in undergraduate nursing students;To investigate the holistic clinical competence of undergraduate nursing students;To analysis the relationship between self-efficacy,clinical learning environment and holistic clinical competence.Methods This subject includes two studies.For the first study,forward-back translation techniques were used in the translation of HCAT according to the Brislin translation model.Cross-cultural adaptation of C-HCAT was carried out through group discussion and pretesting.According to convenience sampling method,totally889 undergraduate nursing students from 2 medical colleges in Anhui province were investigated with a self-designed demographic questionnaire,C-HCAT.Among this population,30 undergraduate nursing students were invited repeatedly to fill out C-HCAT and the test-retest reliability was calculated accordingly.Pearson correlation coefficient and independent sample t-test were used to select items.The reliability of C-HCAT was tested by Cronbach's?coefficient and test-retest reliability(ICC).The validity of C-HCAT was tested by content validity index,face validity,construst validity.For the second study,according to convenience sampling method,totally1518 undergraduate nursing students from 5 medical colleges in Anhui province were investigated with a self-designed demographic questionnaire,C-HCAT,GSES,CLES+T.The statistical analysis mainly included:description analysis,t-test,one-way ANOVE,Pearson correlation,multiple regression analysis and mediating effect analysis.Results Study 1:The Cronbach's?coefficient of C-HCAT was 0.965,the test-retest reliability was 0.928,and the average of all I-CVIs on the scale was 0.972.Five factors were extracted by exploratory factor analysis which explained 60.428%of the total variance.According to the factor structure of original scale,Factor 2 and factor 5are combined to identified four factors,including professional/legal and ethical practice,management of care,leadership and nursing management,Professional development.Confirmatory factor analysis confirmed four-factor model that fitted the data from C-HCAT very well,in which?~2/df=1.466,root mean square residual(RMR)=0.026,goodness of fit index(GFI)=0.913,adjusted goodness of fit index(AGFI)=0.901,incremental fit index(IFI)=0.946,comparative fit index(CFI)=0.947,root mean square error of approximation(RMSEA)=0.033.Study 2:The score of holistic clinical competence in undergraduate nursing students was 105.90±17.82.There was significant difference in the score of holistic clinical competence(P<0.05)at Professional interest,professional volunteering,nursing work employment intention.Professional interest,self-efficacy and clinical learning environment are the factors influencing the holistic clinical competence in undergraduate nursing students.The holistic clinical competence was positively correlated with self-efficacy and clinical learning environment(r=0.471,r=0.380,P<0.01).There was a positive correlation between the self-efficacy and clinical learning environment(r=0.451,P<0.01).Self-efficacy palys a partial mediating role between clinical learning environment and holistic clinical competence.Conclusions C-HCAT is reliable and valid,it can be used to assess clinical competence of undergraduate nursing students in China.Nursing educators and managers can promote the holistic clinical competence of undergraduate nursing students by improving self-efficacy and ameliorating clinical learning environment. |
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