Validity and reliability of the Chinese version of the Watson Caritas Patient Score

BACKGROUND: Watson’s Theory of Human Caring emphasizes ten Caritas Processes®, providing a theoretical foundation for holistic nursing care. The Watson Caritas Patient Score (WCPS) has been validated internationally. However, to date, no culturally adapted Chinese version exists. The aim of this study was to translate and culturally adapt the WCPS into a Chinese version (WCPS-C), and examine its psychometric properties and convergent validity using the Patient Satisfaction with Nursing Care Scale. METHODS: A cross-sectional study was conducted in two phases: (1) translation and cultural adaptation of the WCPS into Chinese, and (2) psychometric testing using two independent samples. Exploratory factor analysis (EFA, n = 104) and confirmatory factor analysis (CFA, n = 221) were also performed. Data were collected from March 1 to September 8, 2025, at five hospitals in Taiwan. Descriptive statistics, Cronbach’s α for reliability, Pearson correlation for convergent validity, EFA with principal axis factoring and Promax rotation, and CFA using AMOS were conducted to evaluate construct validity and model fit. RESULTS: The participants’ demographics did not differ significantly between the EFA and CFA samples. EFA supported a one-factor structure (KMO = 0.813, Bartlett’s p < 0.001), explaining 82.34% of variance, with factor loadings ranging from 0.825 to 0.937. CFA confirmed good fit indices: χ²/df = 0.50, CFI = 1.000, RMSEA = 0.000, SRMR = 0.004; standardized factor loadings ranged from 0.825 to 0.937. Internal consistency was high (Cronbach’s α = 0.935). The WCPS-C scores showed a positive correlation with patient satisfaction (Spearman’s rho = 0.628–0.764, p < 0.001). CONCLUSIONS: The WCPS-C is a culturally relevant psychometric tool for assessing patients’ perceptions of nursing care in Taiwan. It captures the holistic dimensions of nursing care beyond traditional satisfaction measures. It can be applied in clinical settings to evaluate nurses’ caring behaviors, enhance caring competence, and guide quality improvement in nursing practice. CLINICAL TRIAL NUMBER: Not applicable.