Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale.

BACKGROUND

Trust in healthcare systems is an essential determinant of patient satisfaction and healthcare outcomes. Understanding and measuring this trust is essential for improving healthcare services. Due to the lack of a valid and reliable tool in Iran for measuring trust in multidimensional healthcare systems, this study aimed to evaluate the psychometric properties of the Persian version of the Trust in Multidimensional Healthcare Systems Scale (P-TIMHSS).

METHODS

This cross-sectional study was conducted in 2024. The questionnaire was distributed online to family members of students at Iran University of Medical Sciences ( = 411). Face and content validity were assessed qualitatively. Participants were randomly divided into two groups for exploratory ( = 205) and confirmatory factor analysis ( = 206). Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega coefficients. The analyses were performed using Jamovi software version 2.4.14 and Amos version 26.

RESULTS

The exploratory factor analysis identified four factors of Attention, Expertise, Trustworthiness, and Information, explaining 56.3% of the total variance. Internal consistency coefficients ranged from 0.810 to 0.926. The extracted factors showed correlations above 0.50. Fit indices in the confirmatory factor analysis were appropriate (CMIN/DF = 2.427, CFI = 0.939, IFI = 0.939, NFI = 0.90, and RMSEA = 0.059). These results support the reliability and validity of the P-TIMHSS.

CONCLUSION

The P-TIMHSS demonstrates strong psychometric properties, making it suitable for assessing trust in the Iranian healthcare system in national studies. Periodic assessments using this scale are recommended to identify trust deficits and design targeted interventions.