Psychometric testing of the caring assessment tool: Educational version (CAT-Edu©)

Abstract

Background: Caring is fundamental to quality nursing education, fostering effective nurse-patient relationships, empathy, and holistic care. Globally, including in Slovenia, nursing institutions struggle to integrate caring behaviors into curricula due to a lack of culturally sensitive assessment tools. This limits the measurement and development of caring competencies, potentially affecting education quality and patient outcomes. Objectives: To translate and evaluate the psychometric properties of the Caring Assessment Tool-educational version (CAT-edu). Design: A cross-sectional, descriptive study design was used to evaluate the CAT-edu's psychometric properties. Setting: Four nursing faculties, with data collected from October 2021 until February 2022. Participants: A convenience sample of 703 undergraduate student nurses enrolled in first-cycle Bologna degree programs. Methods: The CAT-edu was translated using forward- and back-translation. Content validity indices were calculated to evaluate content validity by nine experts, and ten educators assessed face validity. Construct validity was evaluated through principal component analysis and internal consistency using Cronbach's alpha. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) and RStudio. Results: Content validity was strong, with most items achieving high content validity indices; however, three items (26, 52, and 74) scored slightly lower. Construct validity was confirmed through principal component analysis, with Bartlett's test of Sphericity (p < 0.001) and a Kaiser-Meyer-Olkin value of 0.974 indicating suitability. Seven components explained 59.70 % of the variance. The 62-item version showed high internal consistency (Cronbach's alpha = 0.97). Limitations: The study lacked a test-retest reliability assessment and may have limited potential generalizability due to convenience sampling and specific sample demographics. Conclusions: The first Slovenian version of the CAT-edu for assessing caring behaviors in nursing education is a culturally sensitive and relatively psychometrically robust instrument. It supports faculty development, curriculum enhancements, and institutional policies. Addressing gaps like noncaring behaviors can foster caring competencies and improve patient outcomes.