Psychometric properties of the Chinese version of the attitude and confidence with oral healthcare among nursing students (ACORN) scale: a cross-sectional study

Nursing students’ attitudes and confidence in oral healthcare are essential for service improvement. While the Attitude and Confidence with Oral Healthcare among Nursing Students (ACORN) scale is a validated assessment tool, its reliability and validity in China remain unverified. This study aims to translate the ACORN scale into Chinese and evaluate its validity and reliability among nursing students. This cross-sectional methodological study involved the translation and validation of the ACORN scale into Chinese. A total of 474 nursing students from two universities in China were surveyed between February and April 2024 using the finalized Chinese version of the scale. Eight nursing education experts verified the content validity by assessing the relevance and clarity of the items. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) samples comprised 237 students, respectively, to test the structural validity of the inventory. Internal consistency was assessed using Cronbach’s α and Spearman-Brown split-half reliability, test-retest reliability was evaluated to determine the stability of the scale. A total of 474 students were included. The Chinese ACORN scale consists of 24 items organized into four factors. The item-level and scale-level content validity index was 0.891 and 0.906, respectively. EFA identified four factors, accounting for 72.626% of the cumulative variance; CFA supported a good model fit. The scale demonstrated strong internal consistency (0.938). Additionally, the test-retest and Spearman-Brown split-half reliability were 0.906 and 0.729, respectively. The Chinese ACORN scale demonstrated strong validity and reliability, making it a suitable tool for assessing nursing students’ attitudes and confidence in oral healthcare. Its application can inform targeted nursing curriculum enhancements and training interventions and guide clinical training to better integrate oral healthcare into nursing practice.