Validation of the Spanish version of the EPICC spiritual care competency self-assessment tool for student nurses

Aim: To cross-culturally adapt and psychometrically test the Spanish version of the EPICC Spiritual Care Competency Tool for student nurses and midwives (EPICC_ spa)

Background: Spiritual care is an essential component of holistic nursing and specific training on its competencies
and their evaluation should be mandatory in nursing degree studies. However, assessment instruments of spiritual care competencies among student nurses in Spanish contexts are presently insufficient.

Design: This was a multicentre, descriptive, cross-sectional study in two phases.

Method: Phase 1 involved the translation and linguistic adaptation of the scale through a panel of experts and a
pilot test. Phase 2 involved the evaluation of structural content, internal reliability and construct validity. Data
were collected between January and June 2024.

Results: Twelve of thirteen nursing schools in Madrid, Spain participated, with 642 first- or fourth-year nursing
students as the final sample population. In the content validity analysis based on an expert panel, 28 items
showed good or excellent validity indices. Exploratory and confirmatory factor analyses revealed a bifactor model of the EPICC_ spa, with two dimensions and 16 items: attitudes towards spiritual care (ten items) and knowledge and skills to provide spiritual care (six items). Very good reliability and evidence of construct validity (convergent and differentiation in known groups) were also shown.

Conclusions: The EPICC spa can be a reliable and valid self-assessment tool for spiritual-care competence among nursing students in Spain and Spanish-speaking countries.