Measuring trust in nurses e Psychometric properties of the Trust in Nurses Scale in four countries Minna Stolt a, * , Andreas Charalambous a, b , Laurel Radwin c , Christina Adam d , Jouko Katajisto e , Chryssoula Lemonidou f , Elisabeth Patiraki f , Katarina Sj € ovall g , Riitta Suhonen a, h a University of Turku, Department of Nursing Science, Turku, Finland b Cyprus University of Technology, Department of Nursing Studies, Limassol, Cyprus c Boston VAMC, Boston, MA, USA d St Savvas Anticancer Hospital, Greece e University of Turku, Department of Mathematics and Statistics, Turku, Finland f National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece g Lund University, Department of Health Sciences and Skåne University Hospital, Lund, Sweden h Turku University Hospital and City of Turku Welfare Division, Finland article info Article history: Received 14 May 2016 Received in revised form 24 August 2016 Accepted 14 September 2016 Keywords: Trust Nurse Nursing Scale Cancer care Cross-cultural study Psychometrics Rasch analysis abstract Purpose: The purpose of this study was to examine psychometric properties of three translated versions of the Trust in Nurses Scale (TNS) and cancer patients’ perceptions of trust in nurses in a sample of cancer patients from four European countries. Methods: A cross-sectional, cross-cultural, multi-site survey design was used. The data were collected with the Trust in Nurses Scale from patients with different types of malignancies in 17 units within five clinical sites (n ¼ 599) between 09/2012 and 06/2014. Data were analyzed using descriptive and infer- ential statistics, multivariate methods and psychometrics using exploratory factor analysis, Cronbach's alpha coefficients, item analysis and Rasch analysis. Results: The psychometric properties of the data were consistent in all countries. Within the exploratory factor analysis the principal component analysis supported the one component structure (unidimen- sionality) of the TNS. The internal consistency reliability was acceptable. The Rasch analysis supported the unidimensionality of the TNS cross-culturally. All items of the TNS demonstrated acceptable goodness-of-fit to the Rasch model. Cancer patients trusted nurses to a great extent although between- country differences were found. Conclusions: The Trust in Nurses Scale proved to be a valid and reliable tool for measuring patients’ trust in nurses in oncological settings in international contexts. © 2016 Elsevier Ltd. All rights reserved. 1. Introduction Trust in health care is currently high on the policy agenda (European Commission, 2012; WHO, 2005), primarily because it is claimed that, for a number of reasons, public trust in health in- stitutions and in providers is under threat (Rowe and Calnan, 2006). This importance is reflected in recent publications that consider trust a predicting factor in healthcare service use (Zarei et al., 2015), part of service user evaluation of healthcare (Brennan et al., 2013) and a consequence of the patient-care provider relationship (Dinc and Gastman, 2013). The concept of trust has been reported as an intrapersonal attribute within therapeutic relationships which partially defines the quality of inter-professional relationships (Hupcey et al., 2001). The majority of previous studies about trust have focussed on trust between patients and individual professionals (Brennan et al., * Corresponding author. University of Turku, Department of Nursing Science, 20014, University of Turku, Finland. E-mail addresses: minna.stolt@utu.fi (M. Stolt), andreas.charalambous@cut.ac.cy (A. Charalambous), laurel.radwin@va.gov (L. Radwin), christinaadam7@yahoo.gr (C. Adam), jouko.katajisto@utu.fi (J. Katajisto), clemonid@nurs.uoa.gr (C. Lemonidou), epatiraki@nurs.uoa.gr (E. Patiraki), katarina.sjovall@skane.se (K. Sj€ ovall), suhonen.riitta@kolumbus.fi, riisuh@utu.fi (R. Suhonen). Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon http://dx.doi.org/10.1016/j.ejon.2016.09.006 1462-3889/© 2016 Elsevier Ltd. All rights reserved. European Journal of Oncology Nursing 25 (2016) 46e54