A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population

The importance of trust within health care is widely acknowledged. Measuring patients’ trust in health care systems may contribute
to plans for the financing, delivery, and outcomes of health services. Although many scales are available to measure patient
trust, less attention has been paid to the multidimensional nature of trust in health care systems. The purpose of this methodological
study was to adapt the Multidimensional Trust in Health-Care Systems Scale into Turkish and to evaluate its psychometric properties
for a Turkish patient population. The scale was adapted into Turkish through a translation and back-translation process. The
content validity of the scale was assessed using expert approval. The psychometric properties of the scale were investigated
by collecting data from 232 hospitalised patients in Ankara during theperiod of 1 January–30 December 2010. An exploratory
factor analysis identified that the eigenvalues for the three factors of the scale were 7.30, 2.61, and 1.21; these three
factors explained 65 % of the variance. A confirmatory factor analysis indicated a sufficient model fit for the construct
validity of the scale. Cronbach’s α for the total scale was 0.87, as well as 0.91, 0.82, and 0.61 for the three subscales;
the Spearman-Brown split half reliability coefficient was 0.67. Despite the low internal consistency of the subscale 3, evidence
from this study supports the validity and reliability of the Multidimensional Trust in Health-Care Systems Scale. This instrument
can be used to measure multiple aspects of trust in the health care system; however, as trust is a contextual phenomenon,
further work is needed to test the psychometric properties of this scale both in Turkish and different cultures.