Effective communication is central to nursing practice and underpins therapeutic relationships with patients, families, and other healthcare providers. Deficits in communication can reduce care quality, increase medication errors, prolong length of stay, and decrease patient satisfaction. The concept of patient-centered communication emphasizes empowering patients and families through information sharing, emotional support, empathetic engagement, attention to values and preferences, and active involvement in decision-making. While multiple instruments have been developed to measure communication from patient or caregiver perspectives, fewer tools focus on nurses’ perspectives as primary healthcare providers who enact patient-centered behaviors in clinical settings.
The Patient-Centered Communication Scale (PCCS) was developed to measure nurse-reported aspects of patient-centered communication. Prior to this study, no psychometric evaluation of the PCCS outside the original language had been reported for Iran. The present methodological study aimed to culturally adapt the PCCS into Persian and to examine its validity and reliability in a sample of Iranian clinical nurses.
This methodological study was conducted in hospitals affiliated with Shahroud University of Medical Sciences. The research used a multistep psychometric approach including translation and cultural adaptation, content validity assessment by experts, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing (internal consistency and external stability).
Content validity was examined using qualitative and quantitative methods with specialists in patient-centered communication and nurse–patient communication. During this process experts identified conceptual redundancy between two items and recommended deleting item 4 because it overlapped substantially with item 5. This expert-driven modification informed the item set subjected to factor analysis.
The investigators used convenience sampling to collect two independent samples of clinical nurses, each comprising 150 qualified participants, for a total sample size of 300. The two independent samples allowed separation of exploratory and confirmatory factor analytic procedures. The study was performed within a single university medical center system, and the authors note that the sample may not represent nurses working in other university-affiliated or private facilities in Iran.
Exploratory factor analysis of the Persian PCCS yielded a single-factor solution. The identified factor had an eigenvalue of 8.56 and explained 77.78% of the total variance. The resulting unidimensional structure indicated that the retained items measure a single underlying construct consistent with patient-centered communication as conceptualized in the adaptation process.
Confirmatory factor analysis was conducted on the independent sample to evaluate model fit for the single-factor structure identified in EFA. The CFA supported the single-factor model for the Persian PCCS, providing evidence that the translated instrument’s factor structure is coherent across samples in this study.
Internal consistency of the Persian PCCS was assessed using Cronbach’s alpha and McDonald’s omega. Both coefficients exceeded 0.70, indicating satisfactory internal reliability. External stability (test–retest reliability) was quantified using the intraclass correlation coefficient (ICC), which exceeded 0.80, reflecting favorable reproducibility over time.
These findings collectively support the Persian PCCS as a unidimensional, reliable measure of nurse-reported patient-centered communication in the study setting.
The favorable psychometric indicators suggest that the Persian version of the Patient-Centered Communication Scale (PCCS) can be used to assess nurse-reported patient-centered communication behaviors in clinical settings similar to those studied. A valid and reliable instrument from the nurses’ perspective can help identify factors related to the enactment of patient-centered communication, detect training needs, and evaluate the effectiveness of interventions aimed at improving communication practices. Because nurses are central to day-to-day patient interactions, their perspective complements patient- and caregiver-reported measures and contributes to a more comprehensive understanding of communication processes in practice.
The authors acknowledge limitations affecting generalizability. Data were collected at a single university medical center system, which constrains extrapolation to nurses employed in other Iranian universities, non-university hospitals, and private medical centers. Additionally, the study did not report cross-cultural comparisons beyond the Persian adaptation. The authors state that the underlying data contain potentially identifying and sensitive participant information and therefore are not publicly available; data can be requested from the corresponding author or the university research office under the conditions specified by the institutional Research Ethics Committee.
The study also reported no specific external funding and no competing interests.
The Persian adaptation of the PCCS demonstrated a unidimensional factor structure, satisfactory internal consistency (Cronbach’s alpha and McDonald’s omega > 0.70), and acceptable external stability (ICC > 0.80) in samples of Iranian clinical nurses. These psychometric properties support use of the Persian PCCS to measure nurse-reported patient-centered communication and to evaluate interventions designed to enhance communication in similar clinical settings. However, broader validation across multiple centers and different healthcare contexts in Iran is needed to establish wider generalizability.