Translation and cultural adaptation of the sleep health literacy scale and psychometric validation of the sleep health communication scale

Currently, no practical instrument is available to evaluate sleep health literacy in nurses. This study aimed to translate the Sleep Health Communication scale into Chinese and examine its psychometric properties. Translation was performed following the standard procedures of the classic Brislin translation model. Cross-sectional survey was conducted between May 1 and June 1, 2025, in a large general hospital located in Southeast China. The survey battery consisted of demographic information, the Sleep Health Literacy scale (SHL), and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ). Random subsample 1 ( n = 317) was used for item analysis and exploratory factor analysis (EFA). Random subsample 2 ( n = 318) was utilised to test internal consistency, perform confirmatory factor analysis, and calculate convergent validity and discriminant validity. Forty randomly selected participants were retested one month later to assess test-retest reliability. Six experts in relevant disciplines were recruited to evaluate content validity. Concurrent validity was assessed via Pearson correlation analysis between the total score of the SHC and the overall score of the APSQ. The Chinese version of the SHC scale comprised 2 dimensions with a total of 9 items. Confirmatory factor analysis (CFA) supported this two-factor model with acceptable model fit indices: χ 2 /df = 2.946, RMSEA = 0.078. The overall Cronbach’s α coefficient of the scale was 0.889, and the McDonald’s ω coefficient was 0.894. The test-retest reliability yielded an r value of 0.881, and the two-way mixed-effects model intraclass correlation coefficient (ICC) value of 0.866. The item-level content validity index (I-CVI) ranged from 0.833 to 1.000, and the scale-level average content validity index (S-CVI/Ave) was 0.944. Concurrent validity was calculated by correlating total SHC scores with total APSQ scores; the correlation coefficient was r = − 0.187( p < 0.01). The SHC-C exhibited preliminary reliability and validity. Notably, the overall concurrent validity of this scale with the APSQ was weak. The two-item Critical Application factor exhibited an even weaker, non-significant correlation and limited internal consistency. Its psychometric properties should be further validated using larger and more diverse samples. Not applicable.