Cultural adaptation and psychometric evaluation of the Italian version of the active-empathic listening scale among undergraduate nursing students: A three phase validation study

Aim: To translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing. Background: Active and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients' needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients' needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context. Design: A three-phase validation study. Methods: The tool was first translated and adapted into Italian. A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods. Results: A total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach's alpha (0.877) and Composite-omega (0.875). Conclusions: The Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.