Back to Journals » Patient Preference and Adherence » Volume 13

Psychometric properties of the Persian Health Care Climate Questionnaire (HCCQ-P): assessment of type 2 diabetes care supportiveness in Iran

Authors Matin H, Nadrian H, Jahangiry L, Sarbakhsh P, Shaghaghi A

Received 13 January 2019

Accepted for publication 18 April 2019

Published 15 May 2019 Volume 2019:13 Pages 783—793


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

H Matin,1 H Nadrian,1 L Jahangiry,1 P Sarbakhsh,2 A Shaghaghi1

1Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran

Background: Health-care systems play a key role in responding to the growing problems of patients with type 2 diabetes by supporting their autonomy in providing routine care. The Health Care Climate Questionnaire (HCCQ) was designed to assess patients’ perceived degree of autonomy support within the care practice settings. The main purpose of this study was to translate and evaluate psychometric properties of the Persian version of the HCCQ (HCCQ-P) to be applied among Iranian and other Persian-speaking patients with type 2 diabetes.
Method: Translation/back-translation procedures were carried out to prepare a preliminary draft of the HCCQ-P that was subsequently sent for face and content validity appraisal by a group of 15 health education/promotion and nursing specialists. Minor revisions were performed based on the feedback, and the content validity ratio (=0.91) and content validity index (=0.95) were within the acceptable range. The structural validity of the scale was assessed by exploratory and confirmatory factor analysis.
Results: The exploratory and confirmatory factor analysis outputs(root mean square error of approximation=0.079, comparative fit index=0.976, Tucker Lewis index=0.967, standardized root mean square residual=0.022) demonstrated the proper performance and fitness statistics of the translated HCCQ in a one-dimensional model similar to the original scale. The internal consistency and reliability scores endorsed the validity of the translated measure (α=0.945, intraclass correlation coefficient=0.999, P=0.000).
Conclusion: In this study, the translated HCCQ-P scale showed robust internal validity for its application in the assessment of health-care settings’ supportiveness in care provision to Persian-speaking patients with type 2 diabetes. Future cross-cultural and multidisciplinary studies are recommended to investigate the applicability of the scale in different patients/cultural groups and health-care settings.

Keywords: type 2 diabetes, Health Care Climate Questionnaire, supportive environment

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]