Psychometric validation and cultural adaptation of the Italian version of the ambulance nurse competence scale

Introduction: This study aimed to examine the validity and reliability of the Italian translation of the Ambulance Nurse Competence Scale (I-ANC) through a rigorous psychometric validation process. Ambulance nurses play a critical role in delivering emergency care, making a reliable, culturally adapted tool to assess their competencies essential. In Italy, where nursing practice in pre-hospital settings is expanding, there was a need for a validated tool reflecting the specific competencies of ambulance nurses. Methods: The validation process used a three-phase approach. First, linguistic and cultural adaptation involved forward and backward translation to align with the Italian healthcare context. Second, a panel of experts assessed content and face validity. Finally, construct validity was tested through confirmatory factor analysis (CFA) with a sample of 212 nurses, and reliability was evaluated using Cronbach's alpha. Results: The I-ANC demonstrated strong performance in linguistic translation and cultural adaptation. Content and face validity assessments showed high levels of agreement among experts, confirming the tool's relevance. CFA supported the original four-component structure: (1) professional value-based nursing care, (2) professional development and research, (3) management of community events, and (4) management of serious events. These components explained a significant portion of the variance in the data, and Cronbach's alpha values for each factor exceeded 0.70, confirming internal consistency. Conclusions: The I-ANC is a valid and reliable tool for assessing the competencies of Italian ambulance nurses. Its use can enhance self-assessment, professional development, and the quality of pre-hospital emergency care.