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

Abstract 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 multidimensi...

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Main Authors: Reza Ghanei Gheshlagh, Hamid Sharif-Nia, Arezoo Dehghani, Gholamreza Masoumi, Samantha B. Meyer
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12824-4
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author Reza Ghanei Gheshlagh
Hamid Sharif-Nia
Arezoo Dehghani
Gholamreza Masoumi
Samantha B. Meyer
author_facet Reza Ghanei Gheshlagh
Hamid Sharif-Nia
Arezoo Dehghani
Gholamreza Masoumi
Samantha B. Meyer
author_sort Reza Ghanei Gheshlagh
collection DOAJ
description Abstract 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 (N = 411). Face and content validity were assessed qualitatively. Participants were randomly divided into two groups for exploratory (n = 205) and confirmatory factor analysis (n = 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.
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spelling doaj-art-3b7e79412ea140af9d8f9ea036daca782025-08-20T02:30:45ZengBMCBMC Health Services Research1472-69632025-06-0125111010.1186/s12913-025-12824-4Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems ScaleReza Ghanei Gheshlagh0Hamid Sharif-Nia1Arezoo Dehghani2Gholamreza Masoumi3Samantha B. Meyer4Lahore School of Nursing, The University of LahorePsychosomatic Research Center, Mazandaran University of Medical SciencesEmergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical SciencesEmergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical SciencesSchool of Public Health Sciences, University of WaterlooAbstract 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 (N = 411). Face and content validity were assessed qualitatively. Participants were randomly divided into two groups for exploratory (n = 205) and confirmatory factor analysis (n = 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.https://doi.org/10.1186/s12913-025-12824-4Multidimensional trust in healthcare systems scaleTrustPsychometricsIran
spellingShingle Reza Ghanei Gheshlagh
Hamid Sharif-Nia
Arezoo Dehghani
Gholamreza Masoumi
Samantha B. Meyer
Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
BMC Health Services Research
Multidimensional trust in healthcare systems scale
Trust
Psychometrics
Iran
title Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
title_full Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
title_fullStr Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
title_full_unstemmed Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
title_short Trust under the microscope: psychometric evaluation of the Persian version of the Trust in Multidimensional Healthcare Systems Scale
title_sort trust under the microscope psychometric evaluation of the persian version of the trust in multidimensional healthcare systems scale
topic Multidimensional trust in healthcare systems scale
Trust
Psychometrics
Iran
url https://doi.org/10.1186/s12913-025-12824-4
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