Cultural adaptation and psychometric evaluation of the Italian version of the active-empathic listening scale among undergraduate nursing students: A three phase validation study

AIM

To translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing.

BACKGROUND

Active and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients' needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients' needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context.

DESIGN

A three-phase validation study.

METHODS

The tool was first translated and adapted into Italian. A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods.

RESULTS

A total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach's α (0.877) and Composite-ω (0.875).

CONCLUSIONS

The Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.

Validation of reliability and validity of the Chinese version of the active-empathic listening scale

Background

Active-empathic listening (AEL) is the active and emotional involvement of a listener that can take place in at least three key stages of the listening process. Bodie has developed and validated a self-reported, 11-item, three-factor active-empathic listening scale (AELS) in English with good reliability (Cronbach's alpha = 0.86) to assess AEL abilities. Nevertheless, a Chinese version of the AELS had not been established and validated yet.

Objective

The objective of the present study was to examine the reliability and validity of the Chinese version of the AELS.

Methods

After translating the scale into the Chinese version, 834 college students completed the test. After 4 weeks, 206 participants were tested again on the Chinese AELS to examine retest reliability. The critical ratio method and the item-total correlations were used for the item analysis. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the construct validity. The internal consistency of the scale was analyzed with Cronbach's alpha and McDonald's Omega. Interclass correlation coefficient (ICC) was used to examine the scale's retest reliability. The Interpersonal Reactivity Index (IRI) was used to examine the convergent validity. Pearson correlation analysis was conducted.

Results

Each item of the Chinese AELS had a good discrimination, and the item-total correlation of each item ranged from 0.51 to 0.73. EFA extracted three factors with characteristic root values greater than 1, which could explain 70.72% of the total variance. CFA indicated an adequate fit of the three-factor model (χ2/df = 2.250, root mean square error of approximation [RMSEA] = 0.055, the comparative fit index [CFI] = 0.971, the Tucker-Lewis index [TLI] = 0.959, and the goodness of fit index [GFI] = 0.959). The internal consistency reliability was acceptable (sensing: α = 0.79/ω = 0.78, processing: α = 0.83/ω = 0.83, responding: α = 0.79/ω = 0.79, and AELS: α = 0.87/ω = 0.87). Retest reliability of the scale at 4-week intervals by an ICC was 0.563. The Chinese AELS was significantly correlated with each dimension of IRI.

Conclusion

The reliability and validity of the Chinese AELS met the basic psychometrics requirements. Therefore, the scale can be potentially used to assess the active empathic listening abilities of people in China.

Psychometric Properties of an Emotional Communication Questionnaire for Education and Healthcare Professionals

Educational and healthcare professionals need to develop emotional communication with schoolchildren and patients, respectively. This study aims to analyse the psychometric properties of an instrument that evaluates emotional communication among these professionals. A total of 406 professionals and students of education and health sciences took part in the study. They were administered a questionnaire using a Google Form that collected different elements of emotional communication. An exploratory factor analysis was carried out from which three factors were extracted: Communicative Proactivity, Openness and Authenticity, and Listening. These were supported by confirmatory factor analysis. The internal consistency of the scale is also adequate, ranging from 0.69 to 0.82. This instrument is valid, and, in a self-reported, straightforward and time-efficient manner, can assess the emotional communication of professionals and students of education and health sciences.

Reliability and validity of the Japanese version of the active-emphatic listening scale

Background

Active-emphatic listening is active listening that focuses on empathy. The Active-Empathic Listening Scale (AELS) is a self-report scale comprising three dimensions: sensing, processing, and responding. However, translated versions are not available for languages used in Asian countries, such as Japanese. The aim of the present study was to demonstrate and report on the reliability and validity of the Japanese version of the AELS.

Methods

After the scale was back translated, 728 Japanese university students completed the Japanese AELS. Of those participants, 566 responded to Japanese versions of the Interpersonal Reactivity Index (IRI) and Encode, Decode, Control, and Regulate Model (ENDCOREs) for validation, and the Japanese AELS was administered again to 59 participants after 3 weeks, to determine test-retest reliability. This study used confirmatory factor analysis to validate the scale’s three-factor structure. To evaluate reliability, Cronbach’s α, McDonald’s omega, and intra-class correlation coefficient were calculated. To examine validity, correlation and partial correlation analyses were conducted.

Results

Results indicated that the factor structure of the Japanese AELS was equivalent to that of the original AELS (CFI = .942, TLI = .920, RMSEA = .055). The scale had adequate internal reliability (sensing: α = .64/ ω = .72, processing: α = .61/ ω = .62, responding: α = .68/ ω = .77, total: α = .82/ ω = .86) and a moderate test-retest intraclass correlation coefficient (sensing: .53, 95%Cl [.31–.69], processing: .48, 95%Cl [.26–.65], responding: .52, 95%Cl [.31–.68], total: .51, 95%Cl [.29–.68]). Criterion-related validity was demonstrated by the positive correlation between the Japanese AELS and other measures (IRI and ENDCOREs).

Conclusions

These results suggest that the validity of the Japanese AELS is relatively comparable to the original AELS; however, it will be necessary to determine potential cultural concerns by comparing Japanese culture and other Asian cultures in future studies. The Japanese AELS is expected to be used to measure the outcomes of active listening training in Japan.