Near-death experiences (NDEs) are subjective experiences including prototypical self-related emotional and mystical features (1), which can be considered as an episode of disconnected consciousness (2). Out-of-body experiences (OBEs), the feeling of peace and well-being, altered time perception, seeing a bright light, seeing a tunnel, encountering people or spirits, and a sense of harmony and/or unity are among the typical NDE elements (3–8). Since 1975, when Moody (9) brought the term “NDE” into medical and bestselling literature, interest in NDEs has grown considerably. Since then, more and more NDE testimonies have been collected all around the world. NDEs are increasingly being described as a clear, identifiable physiological and psychological reality with clinical implications (3). NDE, with an incidence of about 20% in cardiac arrest survivors and 15% in patients surviving a protracted severe illness, is not a rare phenomenon (10–12). Currently, the phenomenon of NDEs can be divided into two categories: classical NDEs and near-death-like experiences (NDEs-like). Classical NDEs occurred in life-threatening situations, such as cardiac arrest, perioperative complications, electrocution, near-drowning, asphyxia, or attempted suicide (6, 11–13). On the other hand, it may also occur in non-life-threatening situations, or what are known as NDEs-like (14–19), including epilepsy (20), syncope (21), meditation (22), intense grief and anxiety (16), or drug use (23, 24).

In 2020, Martial et al. (2) suggested a unified framework for “consciousness” based on two original models (2, 25, 26), offering a novel perspective to the investigation of NDE. They considered consciousness as a multi-faceted concept, which has three main dimensions: wakefulness (i.e., eye opening), internal awareness (i.e., environmental stimulus-independent thoughts), and connectedness (i.e., connection to the environment). Classical NDEs are subjective experiences that dissociate the correlation of the three dimensions and can be viewed as inner awareness without contact with the environment and without wakefulness. NDEs-like are a more heterogeneous set of states with the possibility of different levels of wakefulness and connectedness in the presence of inner awareness. The most widespread explanations for the occurrence of NDEs tend to integrate psychological and neurobiological mechanisms (2, 12). Therefore, NDEs provide researchers with a unique perspective to better understand the neurological mechanisms of (disconnected) consciousness (2).

The Greyson scale is the most commonly used measure to assess NDEs (27). However, as elaborated in Martial et al. (28), this questionnaire has several significant limitations, such as not addressing negative NDEs, leading to many cases of overlooked negative NDEs (27, 29–32). As the interest in NDEs increased in recent years, the original scientific tool has no longer met the scientists’ needs, and it is increasingly important to accurately identify near-death experiencers (NDErs) to facilitate empirical research as well as facilitate reproducibility among evaluators. In this context, Martial and colleagues developed the Near-Death Experience Content (NDE-C) scale in 2020 to strictly screen the phenomenology of NDEs (28). They demonstrated that the newly developed scale has good psychometric properties, such as good internal consistency and concurrent validity. This scale notably reevaluated the composition of the NDE scale for negative NDEs. Meanwhile, it solved the problem that distressing NDEs were not quantified in the Greyson scales. Importantly, the NDE-C scale itself does not distinguish between classical NDEs and NDEs-like; It is intended to identify the content of NDEs independent of context. It is rather the context within which the subjective experience has been occurred that will allow for this distinction.

According to nearly 40 years of surveys, the majority of NDEs research has been done in North America and Western Europe, while much less has been done in Asia (33). In the historical background of traditional culture in the East, the exploration of consciousness issues has never left the attention of scholars and monks of traditional Eastern culture. In China, there are a lot of common mental control practices (e.g., meditation) happening in situations that are not life-threatening inducing “NDEs-like,” a series of strong subjective experiences close to the content of the NDE, which also suits for this scale. However, up until today, there has not been a scientific scale to identify and quantify NDEs-like in China. The use of the newly developed NDE-C scale in China may help researchers to better understand and interpret these complex and often life-changing experiences. Meanwhile, it could also be adopted to quantify conscious experiences with the different contexts in Eastern culture. Therefore, it is of great significance to translate and validate the recently developed NDE-C scale into Chinese (28). The official language of the translated scale is Mandarin.

The first purpose of this study was to rigorously translate the original NDE-C scale from English into Chinese. The differences between the two independent translations were slight, owing primarily to differences in language order. The committee’s translation discussion went equally well. In order to adapt to linguistic and cultural differences in different locations where diverse dialects are spoken, cross-cultural adaptation was carried out appropriately, as in Zhang et al. (42).

The second purpose of the present study was to validate the NDE-C in Chinese NDErs. Its internal consistency is good (the Cronbach’s α value of the Chinese version of the NDE-C scale for the total group = 0.85, the Cronbach’s α value of classical NDEs group = 0.88). The Chinese version of the NDE-C scale maintains the original five-factor structure in the confirmatory factor analysis, as opposed to Greyson’s four-factor structure, which was inconsistent with some certain scale items. Compared with the traditional common tool NDE Scale by Greyson, all the items of the Chinese version of the NDE-C scale were worded affirmatively, instead of questions. Also, the Chinese version of the NDE-C scale added items related to negative emotions, which is more in line with the actual situation of NDE case studies (43). We here showed that the Chinese version of the NDE-C scale has good psychometric properties in our sample study and still adapts in an Eastern cultural context.

China is a vast country with a large population, many ethnic groups, and many dialects. In our study, 83% of the participants were agnostics or atheists which also indicates that atheism prevails in China. The same word may have different meanings, all of which may lead to misconceptions of translated concepts. Mandarin, China’s official language, is the language carrier of the Chinese translation of the NDE-C scale, which has the broadest reach and allows the scale to be promoted and utilized in all regions and hospitals in China as well as the Chinese-speaking areas to the greatest extent.

Although this study had important research implications, there are still some limitations. First of all, we have used the English version for Chinese translation and not the French version which is the original version of the NDE-C scale. Secondly, this is a relatively small sample. This is notably due to the specificity of this population, which limited our recruitment. Moreover, the participants were self-selected, therefore there was a potential selection bias, and they may not be representative of the general population. Future studies should study the psychometric properties of the Chinese NDE-C scale in a larger sample of NDEs(−like) experiencers. Another limitation is that we did not collect objective medical information regarding the presence of a life-threatening event.

The Chinese version of the NDE-C scale has been translated and validated in the present study, and is now accessible for use in actual research. This tool can be used to screen people who have experienced an NDEs(−like) and to quantify their subjective experience, thereby leading to promoting the growth of NDEs-related research in China. The Chinese translation of the NDE-C scale can be a valuable instrument for further empirical research on NDEs(−like) with Asian cultural backgrounds. Further investigations will nevertheless be needed to study its psychometric properties. Further research should also be conducted to determine how difficult it is to adopt and propagate Mandarin in a country with various dialects and traditional characters.

The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.

The protocol for this study was conceived and designed by YL, CM, HC, HD, JY, XZ, OG, and SL. YL, JY, CN, and XZ all made important contributions to data collection. Data processing and interpretation were done by YL and MS. YL, YC, CM, HC, XZ, JY, CN, ML, and NH all contributed to the preparation of the manuscript, including drafting and revision. All authors had full access to all the data in the study and had final authority on whether or not to submit it for publication. All authors contributed to the article and approved the submitted version.