Translation and validation of the Chinese version of quality of physician-patient interaction scale

Abstract

Background: While the importance of outpatient physician-patient interaction is increasingly recognized, there remains a lack of effective tools to assess these interactions in mainland China. This gap limits our understanding of the nuances in outpatient physician-patient interactions. Objective: This study aimed to translate the Questionnaire on the Quality of Physician-Patient Interaction (QQPPI) into Chinese and validate its effectiveness in assessing the quality of outpatient physician-patient interactions. Methods: This study recruited 466 outpatients using convenience sampling and was conducted in four phases: (1) translation and back-translation to develop the Chinese version of the QQPPI (QQPPI-C); (2) expert review for cultural and contextual relevance; (3) psychometric validation, including exploratory factor analysis on 140 participants and confirmatory factor analysis, measurement invariance, and convergent validity on the remaining 326; and (4) internal consistency assessment using Cronbach's α and Guttman's λ₄. Results: Among the 466 participants (mean age 48.89 ± 14.93 years; 50.2 % male), 140 were randomly assigned for exploratory factor analysis, which supported a unidimensional scale structure explaining 52.12 % of the variance. The remaining 326 participants were used for confirmatory factor analysis and other validity assessments. confirmatory factor analysis indicated good model fit (χ²/df = 2.338, Root Mean Square Error of Approximation = 0.064, Incremental Fit Index = 0.937, Comparative Fit Index = 0.963, Tucker-Lewis Index = 0.955, and Root Mean Square Residual = 0.031). The QQPPI-C showed excellent internal consistency (Cronbach's α = 0.939, Guttman's λ₄= 0.940), high content validity (scale-level content validity index = 0.968), adequate convergent validity, and measurement invariance across genders. Conclusions: The QQPPI-C is a reliable and valid tool for assessing outpatient physician-patient interaction quality in China. Its use can support clinical communication improvement and research on patient-centered care.