Table 5_Development and psychometric validation of a core competency scale for military nurses in high-altitude extreme environments.docx

BackgroundWith the ongoing evolution of military operations, future high-altitude missions are expected to present significant challenges due to extreme environmental and geographical conditions. As essential members of the medical support system, military nurses play a crucial role in various combat rescue operations—particularly in casualty care under special environmental conditions—where their competency directly influences the effectiveness of medical support. Evaluating casualty care capabilities in extreme settings not only reflects the overall performance of rescue personnel but also provides a foundation for capability development and training. This study developed a core competency scale for high-altitude extreme environment rescue among military nurses (HA-MNCS) and examined its reliability and validity, offering a practical tool for use in training and assessment by managers.
MethodBased on a literature review and semi-structured interviews, an initial item pool was constructed. The scale was refined through expert consultation, group discussions, and a pilot survey. Using convenience sampling, 220 active-duty or civilian nurses from two hospitals in China were recruited. Item analysis, reliability, and validity tests were conducted on the collected questionnaire data.
ResultsThe final version of the scale consists of 36 items across four dimensions: theoretical knowledge, professional skill, comprehensive ability, and personal trait. The item-content validity index (I-CVI) ranged from 0.833 to 1.000, and the scale-content validity index (S-CVI) was 0.978. Exploratory factor analysis (EFA) revealed that Bartlett’s sphericity test χ2 value was 3217.183 (p < 0.001), the KMO coefficient was 0.839, and the cumulative variance explained by the four common factors was 70.040%. The results of confirmatory factor analysis (CFA) indicated that the root mean square error of approximation (RMSEA) was <0.08, the root mean square residual (RMR) was <0.05, and the incremental fit index (IFI) and comparative fit index (CFI) were both >0.9. The Cronbach’s α coefficient of the scale was 0.948, the split-half reliability was 0.810, and the test–retest reliability was 0.962.
ConclusionThe HA-MNCS demonstrates good reliability and validity and can serve as an effective tool for evaluating the core competency of military nurses in high-altitude extreme environment rescue operations. It provides a valuable reference for improving assessment systems and optimizing training programs.

研究背景：随着军事行动的持续演进，未来高空任务因极端环境与地理条件将面临诸多严峻挑战。作为医疗保障体系的核心组成人员，军队护士在各类作战救援行动中发挥着至关重要的作用，尤其是在特殊环境下的伤员救治工作中，其胜任力直接影响医疗保障的效能。对极端环境下伤员救治能力进行评估，不仅能够反映救援人员的整体履职表现，还可为能力建设与培训工作提供依据。本研究编制了军队护士高空极端环境救援核心胜任力量表（HA-MNCS），并对其信效度进行检验，可为管理者开展培训与评估工作提供实用工具。
研究方法：本研究通过文献回顾与半结构化访谈构建初始题项池，随后经专家咨询、小组讨论及预调查对量表进行修订。采用便利抽样法，招募中国两家医院的220名现役或文职护士作为研究对象。对回收的问卷数据进行题项分析、信度与效度检验。
研究结果：最终版量表共包含36个题项，涵盖理论知识、专业技能、综合能力与个人特质4个维度。量表的内容效度指标（item-content validity index, I-CVI）取值范围为0.833~1.000，量表内容效度指数（scale-content validity index, S-CVI）为0.978。探索性因素分析（Exploratory Factor Analysis, EFA）结果显示，巴特利特球形检验χ²值为3217.183（p<0.001），KMO统计量为0.839，4个公因子累计解释方差贡献率为70.040%。验证性因素分析（Confirmatory Factor Analysis, CFA）结果表明，近似误差均方根（root mean square error of approximation, RMSEA）<0.08，残差均方根（root mean square residual, RMR）<0.05，增量拟合指数（incremental fit index, IFI）与比较拟合指数（comparative fit index, CFI）均>0.9。量表的克朗巴赫α系数为0.948，分半信度为0.810，重测信度为0.962。
研究结论：HA-MNCS具有良好的信度与效度，可作为评估军队护士高空极端环境救援核心胜任力的有效工具，为完善评估体系、优化培训方案提供了重要参考。