Purpose: Hemiplegic patients often experience malnutrition and feeding risks due to disabilities and
inadequate nursing support; nursing roles regarding mealtime assistance remain unclear in China.
Therefore, this study aimed to clarify the core knowledge and skills of nursing competency regarding
mealtime assistance for hemiplegic patients in China.

Methods: A cross-sectional survey of self-administered questionnaire to 640 nurses (response rate:
57.7%) from two tertiary teaching hospitals and two sanatoriums was conducted. Survey content
included 25 items regarding the mealtime assistance competency plus 6 items on demographic characteristics. The factor structure of the 25 items was explored and verified by exploratory and confirmatory factor analysis. Its reliability was confirmed by Cronbach's alpha.

Results: Three factors including 22 items with a cumulative rate of 60.9% were identified: “Assistance
knowledge and skills for acute period”, “Knowledge about assistance and guidance for recovery period,” and “Professional basic knowledge regarding hemiplegia.” Its reliability was ensured with Cronbach's alpha ranging from .86 to .96. In addition, evidence for its construct validity was obtained, as structural equation modeling revealed a good fit to the data within the allowable range based on various fit indices.

Conclusion: This study clarified the core knowledge and skills regarding mealtime assistance competency for hemiplegic patients, with “Assistance for acute period” most concerned, followed by “assistance and guidance for recovery period,” and “Professional basic knowledge,” and the latter two need more attention. Obtained results can provide useful evidence for competent nursing practice to improve the quality of mealtime assistance for hemiplegic patients in China.