Contextual Adaptation and Psychometric Evaluation of the Healthcare Professional Humanization Scale for Undergraduate Nursing Students: The HUMAS-E Study

Abstract Background The Healthcare Professional Humanization Scale (HUMAS) was developed for nursing professionals, but some items presume autonomous practice and extensive clinical experience. This study aimed to contextually adapt HUMAS for undergraduate nursing students and examine the psychometric properties of the resulting HUMAS-E. Methods The adaptation included review by 15 nursing students, assessment by a multidisciplinary committee of six experts, and pretesting with 10 additional students. The psychometric evaluation included 344 Spanish undergraduate nursing students. Item performance, internal consistency, convergent and discriminant evidence, and structural validity were examined. Confirmatory factor analyses were based on polychoric correlations and diagonally weighted least squares estimation. Results The correlated five-factor model showed adequate fit: χ²(142) = 273.22, p  < 0.001; CFI = 0.989; TLI = 0.987; RMSEA = 0.052, 90% CI [0.043, 0.061]; and SRMR = 0.066. Standardized factor loadings ranged from 0.474 to 0.954. Ordinal alpha ranged from 0.822 to 0.934, and composite reliability ranged from 0.821 to 0.935. Average variance extracted exceeded .50 for four dimensions and was 0.489 for Affection. Item 19 showed the lowest loading, although its corrected item-total correlation remained acceptable. Conclusions HUMAS-E retained the original five-factor configuration and showed preliminary evidence of structural validity and internal consistency. Dimensional scores should be prioritized because Affection behaved comparatively differently and widespread ceiling effects may limit discrimination among students with high scores. Further studies should examine measurement invariance, external validity, temporal stability, and responsiveness.