Objective To validate the reliability and validity of the Narrative Competence Scale (NCS) among oncology healthcare providers. Methods A total of 324 oncology healthcare providers from 6 hospitals in Taizhou were surveyed using the General Information Questionnaire, NCS, Jefferson Scale of Empathy-Health Professions (JSE-HP), and Caring Ability Inventory (CAI). The 27th/73rd percentiles method was used to test the discriminatory power of each item of the NCS, and Pearson correlation analysis was applied to evaluate the correlations between the score of each item and that of its corresponding dimension. Cronbach's α coefficient was used to assess the internal consistency of the scale, and split-half reliability was calculated. With JSE-HP and CAI as criteria, Pearson correlation analysis was used to test the criterion validity of the NCS; exploratory factor analysis and confirmatory factor analysis were used to evaluate the construct validity of the NCS. Results There were statistically significant differences in all items of NCS between the high-score group (participants scoring in the top 27% on the NCS) and the low-score group (participants scoring in the bottom 27% on the NCS) (all P<0.01), and the Pearson correlation coefficients between score of each item and its corresponding dimension ranged from 0.483 to 0.687 (all P<0.01). Results of the reliability analysis showed that the Cronbach's α coefficient of the overall NCS was 0.899, and the Cronbach's α coefficients of the "Attention and Listening", "Understanding and Responding", and "Reflection and Representation" dimensions were 0.725, 0.819, and 0.682, respectively; after correction using the Spearman-Brown unequal-length formula, the split-half reliability of the overall scale was 0.894, and the split-half reliabilities of the "Attention and Listening", "Understanding and Responding", and "Reflection and Representation" dimensions were 0.768, 0.838, and 0.673, respectively. Results of validity analysis showed that: (1) criterion validity: the total score of NCS and its dimension scores were positively correlated with the total scores of JSE-HP and CAI (r=0.433-0.562; all P<0.01); (2) exploratory factor analysis: Bartlett's test of sphericity yielded a χ2 value of 2,176.585 (P<0.001), with a KMO value of 0.92, and using principal component analysis with varimax rotation, five common factors were extracted; (3) confirmatory factor analysis: the following results were yielded: χ2=447.553, df=321, χ2/df=1.394, goodness-of-fit index=0.908, comparative fit index=0.933, root mean square error of approximation=0.035, Tucker-Lewis index=0.927, and standardized root mean square residual=0.046. Conclusion The NCS demonstrates good discrimination, reliability, validity, and internal consistency for assessing narrative competence among oncology healthcare providers. It can serve as an effective tool for this population, although its factor structure requires further validation in future studies.

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