Translation, Validation and Exploration of the Chinese Version of the Health Care Climate Questionnaire Among Hypertensive Patients in Healthcare Settings

Healthcare providers' autonomy support influences patients' health behaviors. The Health Care Climate Questionnaire (HCCQ) effectively measures perceived autonomy support in healthcare settings, but its Chinese version lacks proper reliability and validity testing, hindering objective evaluations in China. This study aimed to cross-culturally adapt and validate the HCCQ for assessing perceived autonomy support among Chinese hypertensive patients. Following the Brislin translation model, the Chinese version of the HCCQ was adapted. From September 2023 to January 2024, 375 hospitalized hypertensive patients from a Guangzhou tertiary hospital completed the adapted questionnaire. Exploratory (EFA) and confirmatory factor analysis (CFA) were used to test the structural validity; internal consistency and item-total correlations were used to assess reliability. After excluding invalid questionnaires, this study finally analyzed data from 357 patients (with 105 cases used for EFA in the first stage and 252 cases used for CFA in the second stage). Consistent with the original questionnaire, the Chinese version of the HCCQ contains a total of 15 items and extracts one common factor, which explains 66.019% of the variance. According to the CFA results, the fitted model meets each goodness-of-fit index. The Cronbach's α coefficient of the Chinese version of the HCCQ is 0.961. Within the scope of this study, the Chinese version of the HCCQ demonstrates good validity and reliability in measuring the perceived autonomy support of hypertensive patients in healthcare settings, which can provide some reference for related research. To a certain extent, the Chinese version of the HCCQ can assist health professionals in assessing and guiding patients' perceived autonomy support.