Structural Validity and Internal Consistency of the Patient’s Perspective of Technological Competency as Caring in Nursing Scale (PP-TCCNS): A Confirmatory Factor Analysis of a Patient-Reported Measure

Background/Objectives: Nurses increasingly deliver care through medical technology, and patients’ views of whether this care remains caring need to be measured. Existing instruments based on Locsin’s theory of Technological Competency as Caring in Nursing (TCCN) are completed by nurses or other healthcare providers. This study examined the structural validity and internal consistency of the Patient’s Perspective of Technological Competency as Caring in Nursing Scale (PP-TCCNS), a 42-item instrument developed in a previous modified Delphi study. Methods: In this cross-sectional study, reported according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), 513 adult inpatients in 13 hospitals in the Philippines completed a web-based survey. Confirmatory factor analysis was used to refine the hypothesized six-factor model and compare it with alternative models. Robust and ordinal estimation, split-sample validation, and measurement invariance by sex and age were also examined. Results: The 42-item model fitted acceptably but showed local strain. Removing 15 redundant items produced a 27-item six-factor model with good fit (comparative fit index = 0.970; root mean square error of approximation = 0.059). This model fitted slightly better than the alternative models and was invariant across sex; invariance across age groups should be interpreted with caution because the latent covariance matrix in the older group was not positive definite. However, the factors were highly correlated (0.87–0.98), and discriminant validity was not supported. A dominant general factor explained most of the common variance (omega hierarchical = 0.975; explained common variance = 0.925), and the subscales carried little unique reliable variance. Total-score reliability was high (Cronbach’s α = 0.987). Older participants rated their care slightly more positively. Ceiling effects were marked (26.3% of participants obtained the maximum total score), and 30% of respondents gave identical answers to all items; excluding them did not change the conclusions. Conclusions: The 27-item PP-TCCNS showed preliminary evidence of structural validity and internal consistency as an essentially unidimensional measure. A total score is recommended, and the six domains should be treated as a content framework rather than as separate subscales. Hypotheses testing, cognitive interviews with patients, and replication in independent samples are needed. This study was not registered.