Table 1_Development and psychometric validation of a health literacy competency scale for nurses, and its application in a cross-sectional survey: a methodological study.docx

Objectives<p>This study aimed to develop the Health Literacy Competencies Scale for Nurses (HLC-N) and examine the current status and influencing factors of health literacy competencies (HLC) among nurses in China.</p>Design<p>A multi-phase methodological study consisting of three stages: (1) item generation (literature review, semi-structured interviews with 12 nurses, a two-round Delphi process with 16 experts, and pilot testing with 30 nurses); (2) psychometric validation (item analysis, exploratory factor analysis [EFA], confirmatory factor analysis [CFA], and reliability testing); and (3) a cross-sectional survey to examine current status and influencing factors.</p>Setting<p>Psychometric validation was conducted across general hospitals in Chongqing, Sichuan, and Zhejiang provinces (July–August 2025).

The cross-sectional survey was carried out in general hospitals across three districts of Chongqing, China (August–September 2025).</p>Participants<p>Psychometric validation included 860 in-service nurses (467 for EFA; 393 for CFA and reliability; 81 for test–retest). Inclusion criteria: registered nurses with ≥1 year of clinical experience. Exclusion criteria: intern nurses, refresher nurses, or those who had previously participated in scale development.