Adaptation and validation of Spanish version of the Inpatient Dignity Scale in hospitalized patients: a psychometric study

Abstract

Hospitalization; Nursing care; Patient-centered care

Hospitalización; Cuidados de enfermería; Atención centrada en el paciente

Hospitalització; Cures d'infermeria; Atenció centrada en el pacient

Background Maintaining dignity in hospitalized patients is fundamental in nursing care and healthcare quality. In Spain, there is no validated tool to quantitatively assess patient dignity during hospitalization. The Inpatient Dignity Scale has been developed and validated in other countries, but its cross-cultural adaptation and psychometric evaluation in Spanish have not yet been conducted. Objective To perform cross-cultural adaptation and psychometric validation of the Inpatient Dignity Scale in Spanish, evaluating its factorial structure, reliability, and validity. Methods A methodological study was conducted in two phases: (1) translation and cross-cultural adaptation following international standards, and (2) psychometric validation through confirmatory factor analysis and assessment of internal consistency using Cronbach's alpha (α) and McDonald's omega (Ω) coefficients. The sample included 553 hospitalized patients from four hospitals in Barcelona, Spain. Results The confirmatory factor analysis confirmed the original four-factor structure of the Inpatient Dignity Scale, maintaining the dimensions of respect as a human being, respect for personal feelings and time, respect for privacy, and respect for autonomy. Model fit indices were adequate (χ²/df = 5.7 for expectations, 4.3 for satisfaction; CFI ≥ 0.90; RMSEA ≤ 0.08). Internal consistency was high across all dimensions (α ≥ 0.88, Ω ≥ 0.92), indicating robust reliability. Conclusions The Spanish version of the Inpatient Dignity Scale in Spanish is a valid and reliable instrument for assessing expectations and satisfaction with dignity in hospitalized patients. Its use can facilitate research on dignity in healthcare and contribute to improving patient-centered care.

This study was supported by external funding from the Fundació Infermeria i Societat through the Support for Nursing Research Projects program Ajudes a projectes de Recerca Infermera (COIB), Number: PR-554/2022. Additionally, it also received funding from the Fundació Victor Grifols i Lucas, Number: PR-2023.