Translation and Validation of the Korean Version of the Revised Health Care System Distrust Scale (HCSD-K) in Korean American Women

Background: Trust in the healthcare system is a major contributor for racial disparities in health and health care. We aimed to formally translate and cross-culturally adapt the Korean version of the Revised Health Care System Distrust (HCSD-K) scale with a sample of Korean American women and examine the psychometric properties of the HCSD-K scale. Methods: Ten Korean American women participated in the cognitive interview. A self-administered questionnaire was completed by 196 Korean American women aged 50–74 years. Instrument adaptation was performed using committee-based translation and cognitive interviewing. Construct validity, convergent validity, and internal consistency were examined to evaluate the psychometric properties of the HCSD-K scale. Results: The translated instrument was found to be semantically sound. A confirmatory factor analysis revealed a two-factor structure with an excellent fit. Convergent validity was supported by correlations between the HCSD-K scale and both the Perceived Discrimination in Health Care and Trust in Physician scales. Cronbach’s alpha for the total HCSD-K was 0.83. Conclusion: The nine-item HCSD-K scale demonstrated satisfactory reliability and validity. It is an appropriate instrument for measuring healthcare system distrust in Korean American women. Further study is needed to confirm the study results in a gender-mixed Korean population.