Cultural Adaptation and Psychometric Validation of the Persian Family Involvement in Care Questionnaire in Cardiac Surgery Inpatient Settings

Background: Family involvement is an important component of patient- and family-centered care in hospital settings, particularly when patients experience physical dependency, emotional vulnerability, and complex care needs. In cardiac surgery-related inpatient settings, family caregivers may contribute to communication, care participation, emotional support, and shared decision-making. However, evidence regarding culturally adapted and psychometrically evaluated Persian-language instruments specifically assessing family caregivers perceived involvement in inpatient care remains limited, particularly in the Iranian inpatient context. Purpose: This study aimed to translate and culturally adapt the Family Involvement in Care Questionnaire (FICQ) into Persian and evaluate its psychometric properties among family caregivers of patients hospitalized in cardiac surgery-related inpatient settings in Iran. Methods: This methodological cross-sectional study was conducted between May and October 2025 among 320 family caregivers recruited from cardiac surgery-related inpatient settings at teaching hospitals affiliated with Mashhad University of Medical Sciences, Iran. The translation and cultural adaptation process followed established international guidelines. Face and content validity were assessed, and construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) in two independent subsamples. The Persian FICQ consisted of 16 items covering three domains of family involvement. For construct validity, the total sample was divided into two mutually exclusive subsamples for Exploratory Factor Analysis (EFA; n = 160) and Confirmatory Factor Analysis (CFA; n = 160). Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega, and test–retest reliability was evaluated using the Intraclass Correlation Coefficient (ICC). Results: EFA supported a three-factor structure consistent with the original FICQ domains (Information and Communication, Participation in Care and Decision-Making, and Support and Respect), explaining 49.0% of the total variance. CFA supported acceptable model fit (χ²/df = 2.13, RMSEA = 0.069, CFI = 0.96, TLI = 0.95, SRMR = 0.045). Convergent and discriminant validity were supported by the reported AVE, CR, and discriminant-validity criteria. The Persian FICQ demonstrated high internal consistency (Cronbach’s alpha = 0.961; McDonald’s omega = 0.958) and test–retest reliability (ICC = 0.996, 95% CI: 0.993–0.998). Conclusion: The findings provide evidence supporting the validity and reliability of the Persian FICQ for assessing family caregivers perceived involvement within cardiac surgery-related inpatient settings. Further validation in other clinical contexts is warranted before broader application.