Validating the Taipei Holistic Screening Scale (THSS) as a bedside humanities-informed tool for person-centred communication and education
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Background Effective communication and holistic understanding of patients' needs are essential in person-centred medical education. However, few validated tools exist that simultaneously support clinical practice and educational development. This study aimed to validate the Taipei Holistic Screening Scale (THSS), a patient self-report instrument designed to identify holistic distress across four dimensions and to foster person-centred communication within hospital-based learning environments. Methods A retrospective validation study was conducted using content analysis and exploratory factor analysis. Sixteen multidisciplinary experts evaluated the scale's relevance, clarity, and comprehensiveness. Medical records from 2,691 hospitalized patients were analysed to assess the psychometric properties of the revised scale. Results The preliminary THSS achieved high content validity (CVR = 0.58, I-CVI = 0.91, S-CVI = 0.91), though revisions were made to the psychological distress domain based on expert input. The modified THSS demonstrated excellent internal consistency (Cronbach’s alpha = 0.94) and construct validity (KMO = 0.95). Four factors were identified—physical discomfort, psychological distress, spiritual distress, and need for social and family support—accounting for 63.58% of the total variance. Cross-loading of some items reflected the intertwined nature of psychosocial and spiritual experiences in patient care. Conclusion The THSS operationalises medical-humanities goals by structuring reflective, empathetic, and interprofessional communication during inpatient care and training. It is a valid and reliable tool that may be used not only for clinical screening but also as a pedagogical resource in medical education. Its structured framework can support communication training, reflective practice, and interprofessional dialogue. The integration of the THSS into educational settings may foster deeper engagement with person-centred care and medical humanities.
