Table 4_Translation, cultural adaptation, and psychometric testing of the measure for unfinished care among nursing assistants in long-term care homes in China.docx

ObjectiveTo translate and culturally adapt the Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) into Chinese and to examine its preliminary psychometric properties among nursing assistants working in Chinese long-term care (LTC) homes for older adults.
MethodsAfter obtaining permission from the original developers, the BERNCA-NH was translated and culturally adapted through forward translation, back-translation, synthesis, cognitive interviews, and expert review. A cross-sectional survey was conducted among 251 nursing assistants recruited by convenience sampling from long-term care facilities in China. Descriptive statistics, item analysis, exploratory factor analysis, and internal consistency testing were performed.
ResultsWe identified three main challenges during the translation and cultural adaptation of the BERNCA-NH for use in Chinese LTC homes: syntactic and idiomatic differences between English and Chinese, mismatch between some original care scenarios and the local LTC context, and multiple possible Chinese interpretations of certain English expressions. The Chinese version of the BERNCA-NH showed good overall internal consistency (Cronbach’s α = 0.815). The KMO value was 0.746 and Bartlett’s test of sphericity was significant (χ2 = 1579.889, df = 210, p < 0.001), indicating suitability for factor analysis. Exploratory factor analysis supported a structure of five formal subscales and one single-item observation indicator, with a cumulative explained variance of 60.71%. The Cronbach’s α coefficients of the five subscales ranged from 0.622 to 0.764.
ConclusionThe Chinese version of the BERNCA-NH showed acceptable preliminary psychometric properties and may serve as a preliminary tool for assessing unfinished care among nursing assistants in Chinese LTC homes, although further validation is needed. It may help identify priority areas for care improvement and provide support for quality assessment, management, and improvement in LTC homes.