Their approach was designed for the hospital security workforce, which the study notes includes personnel who interact with patients and families in emotionally complex and potentially conflict-prone situations. Before the survey, the research team developed an initial item pool using a literature review, narrative medicine and medical humanities frameworks, the Nominal Group Technique, content-validity assessment and adaptation to the work context of hospital security personnel. Scale development followed a theory-driven adaptation approach based on the classical conceptualization of narrative competence and previously validated instruments.

The researchers then surveyed 645 hospital security personnel from 17 hospitals in Zhejiang Province. This cross-sectional design provided the sample used for the psychometric evaluation, which included item analysis, content-validity assessment, exploratory factor analysis, confirmatory factor analysis, convergent-validity assessment and internal-consistency reliability testing. The final HSPNCS contains 36 items arranged into nine first-order subdomains nested within three higher-order dimensions.

Self-reflection, empathy and professionalism form the upper level of this structure. Internal consistency was excellent for the total scale, which produced a Cronbach’s alpha of 0.967. The three higher-order dimensions also had strong internal-consistency coefficients, ranging from 0.911 to 0.945.

Content validity was acceptable, with an S-CVI/Ave of 0.972. Exploratory factor analysis supported the proposed multidimensional structure, and confirmatory factor analysis indicated acceptable model fit. Composite reliability and average variance extracted values also supported the scale’s internal consistency and convergent validity.

Together, these results provide preliminary statistical support for using the HSPNCS to assess the specified three-dimensional construct in the population studied. Despite these encouraging results, the authors characterized the evidence as preliminary. The survey was cross-sectional and included hospital security personnel from one Chinese province, so the findings do not establish whether the factor structure will be reproduced in independent, multicenter or culturally diverse samples.

The study also did not evaluate test–retest reliability, external validity or responsiveness to training interventions. Further research is needed to examine those properties before the scale’s stability and sensitivity to change can be judged. Within the limits of the study, the HSPNCS may be useful for assessing narrative competency and identifying potential training needs in the hospital security workforce.

The authors specifically proposed further studies using independent, multicenter and culturally diverse samples to confirm the factor structure and test the scale’s test–retest reliability, external validity and responsiveness to training.

Subject of Research: Psychometric development of a narrative competency scale for hospital security personnel

Article Title: Development and psychometric validation of the hospital Security Personnel Narrative Competency Scale (HSPNCS)

Article References: Fang, B., Guo, L., Zhang, H., Yang, Y., Wu, R., Wu, J., Jiang, S., & Zhu, L. (2026). Development and psychometric validation of the hospital Security Personnel Narrative Competency Scale (HSPNCS). BMC Health Services Research, 26(1), Article 1275. https://doi.org/10.1186/s12913-026-15542-7

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15542-7

Keywords: hospital security personnel, narrative competency, scale development, psychometric validation, self-reflection, empathy, professionalism, factor analysis, content validity, China, Development, psychometric