Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Arabic Consumer Assessment of Healthcare Providers and Systems—Clinician and Group Survey (CG-CAHPS): A Cross-Sectional Study

Monir M Almotairy,1,2,* Hamza Moafa,3,* Ahmed Nahari,4 Arwa Alhamed,5– 7 Ahmad Aboshaiqah,1 Shamsa Alanazi,8 Hussain Alomar,9 Amal H Alshareef,10 Hajer Alsabaa,10 Essa Hakamy,1 Rahaf Meshal Alotaibi11 1Department of Nursing Administration and Education, King Saud University, College of Nursing, Riyadh, Saudi Arabia; 2Department of Health Systems and Nursing Education, Dr. Sulaiman Al Habib College for Knowledge, Riyadh, Saudi Arabia; 3Department of Community and Psychiatric Mental Health Nursing, King Saud University, College of Nursing, Riyadh, Saudi Arabia; 4Department of Medical Surgical Nursing, King Saud University, College of Nursing, Riyadh, Saudi Arabia; 5College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 6King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 7Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; 8King Fahad Medical City, Riyadh, Saudi Arabia; 9King Abdulaziz Medical City, Riyadh, Saudi Arabia; 10King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 11King Saud University Medical City, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Monir M Almotairy, Email [email protected]; [email protected]: Patient experience is a vital component of healthcare quality, playing a significant role in patient-centered care. Despite the global applicability of the Consumer Assessment of Healthcare Providers and Systems—Clinician and Group Survey (CG-CAHPS), there is a lack of reliable, culturally adapted instruments for assessing patient experience in Arabic-speaking populations. Therefore, we translated, adapted, and validated an Arabic version of the CG-CAHPS to assess patient experiences in Saudi Arabia.Patients and Methods: This cross-sectional study surveyed a convenience sample of 281 outpatients at two heart failure clinics to evaluate the psychometric properties of the Arabic CG-CAHPS—including structural validity, criterion validity, and reliability. The survey consisted of four domains—Access to Care; Communication with Healthcare Professionals; Care Coordination; and Helpful, Courteous, and Respectful Staff. Structural validity was assessed using Confirmatory Factor Analysis (CFA) Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI), both with values greater than 0.90, as well as the Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR). Reliability was evaluated via Cronbach’s alpha (α) for internal consistency, while criterion validity was tested through inter-item correlations with the overall ratings for the recent visit and healthcare provider.Results: The confirmatory factor analysis supported the hypothesized four-factor model, demonstrating adequate structural validity and a good fit (CFI =0.927, TLI =0.906, RMSEA =0.097, and SRMR =0.083). All factor loadings were significant (p < 0.001), ranging from 0.57 to 0.93. Criterion validity was supported by strong correlations between the survey domains and the patient ratings regarding visits and providers—of which the Helpful, Courteous, and Respectful Staff domains showed the highest correlation (r=0.561). Cronbach’s alpha demonstrated high internal consistency (α=0.909)—with each domain exceeding the 0.70 threshold.Conclusion: The Arabic CG-CAHPS is a reliable and valid tool for assessing patient experiences in Saudi healthcare settings. Its application can facilitate the enhancement of patient-centered care and contribute to ongoing efforts to improve healthcare quality in Saudi Arabia. Future research should assess the tool’s applicability in other healthcare contexts and regional populations.Keywords: psychometrics, Saudi Arabia, patient-centered care