Ghanei Gheshlagh Reza, Sharif-Nia Hamid, Dehghani Arezoo, Masoumi Gholamreza, Meyer Samantha B
Lahore School of Nursing, The University of Lahore, Lahore, Pakistan.
Nursing Department, Biruni University, Istanbul, 34010, Turkey.
BMC Health Serv Res. 2025 Jun 4;25(1):798. doi: 10.1186/s12913-025-12824-4.
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).
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.
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.
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.
对医疗保健系统的信任是患者满意度和医疗保健结果的重要决定因素。理解和衡量这种信任对于改善医疗服务至关重要。由于伊朗缺乏用于衡量对多维医疗保健系统信任的有效且可靠的工具，本研究旨在评估《多维医疗保健系统信任量表》波斯文版（P-TIMHSS）的心理测量特性。
本横断面研究于2024年进行。问卷通过网络分发给伊朗医科大学学生的家庭成员（n = 411）。定性评估表面效度和内容效度。参与者被随机分为两组进行探索性（n = 205）和验证性因素分析（n = 206）。使用克朗巴赫α系数和麦克唐纳ω系数计算内部一致性。分析使用Jamovi软件2.4.14版和Amos 26版进行。
探索性因素分析确定了关注、专业知识、可信度和信息四个因素，解释了总方差的56.3%。内部一致性系数范围为0.810至0.926。提取的因素显示相关性高于0.50。验证性因素分析中的拟合指数合适（CMIN/DF = 2.427，CFI = 0.939，IFI = 0.939，NFI = 0.90，RMSEA = 0.059）。这些结果支持了P-TIMHSS的可靠性和有效性。
P-TIMHSS表现出强大的心理测量特性，使其适用于在全国性研究中评估对伊朗医疗保健系统的信任。建议使用该量表进行定期评估，以识别信任缺陷并设计针对性干预措施。
