Translation, cross-cultural adaptation and preliminary validation of the Dutch version of the TOGETHER questionnaire - a tool designed to assess how family members of patients perceive their involvement in the care provided by nurses.

Authors

Thom J T Westdorp, Jolanda M Maaskant, Julie Cussen, Michael J Ireland, Andrea P Marshall, Anne M Eskes

Published in

International journal of nursing studies advances. Volume 11. Pages 100635. Epub Jul 20, 2026.

Abstract

Family-centered care improves knowledge, satisfaction and well-being for patients and families. However, it is still insufficiently implemented in adult hospital care even though family want more involvement. Understanding their experiences is essential to improve the collaboration between family and nurses.
To explore the translation, cross-cultural adaptation, structural validity, and reliability of the TOGETHER questionnaire within the Dutch context. The TOGETHER questionnaire is a tool designed to assess how family members of patients perceive their involvement in the care provided by nurses.
Cross-sectional data collection of the TOGETHER questionnaire.
19 nursing wards of a Dutch university hospital.
A total of 286 family members of patients that were admitted to a participating hospital ward were included.
The 23-item questionnaire was translated and assessed by five family members and two healthcare professionals prior to distribution. Family members of adult patients admitted to a university hospital ward were asked to complete the questionnaire. Structural validity was assessed using exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.
In total 286 family members completed the questionnaire. Six items were removed because of low correlations or cross-loadings on multiple factors. The resulting structure of the questionnaire consisted of 17 items, loading onto one of three factors (Collaboration, Involvement and Communication), together explaining over half of the variance. All the factors demonstrated good internal consistency.
The exploration of the Dutch adaptation of the TOGETHER questionnaire suggests strong psychometric properties. The questionnaire can be used to evaluate the experiences and perceptions of family members regarding their involvement in care by nurses, enabling hospital wards to identify strengths and areas for improvement in the delivery of family-centered care.
not registered.
Family members of patients admitted to the nursing ward and healthcare professionals evaluated the clarity and relevance of the translated questionnaire.

PMID:
42568870
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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