Development and Validation of a Bio-centric Acting questionnaire based on the Biocentric Health Management Theory

Background : The bio-centric worldview is an approach based on human understanding and feeling of being a part of nature through affective experiences and ability to connect with life. The essence of biocentric-acting is life and the connection with the ‘holiness’ and ‘enjoyment’ of life. It seems that this sacred connection with life has been lost in many communities, especially among medical service workers, and the individual and widespread identity crisis that has resulted from the recent Covid-19 pandemic shows the necessity of re-establishing this connection. However, there is no standardized instrument for measuring Bio-centric Acting. This study aims to develop and assess, for the first time, the psychometric properties of biocentric-acting based on the bio-centric health management theory (BHMT) as a theoretical framework and to test it in an Iranian context. Methods : In this methodological study, items were extracted from relevant literature according to the specified objectives of the BHMT. The first draft of the biocentric-acting questionnaire for prehospital staff was designed based on BHMT with the Hybrid concept development approach (HCDA). Then, the psychometric properties, including face content and construct validity as well as reliability, were analyzed. Results : All explored items were categorized as antecedent, attribute, or consequence based on the HCDA. Subsequently, 131 items related to attributes were chosen for further analysis in the study. In the following step, face and content validity of the questionnaire were assessed by 11 prehospital staff and 29 experts. A total of 81 items were retained for Exploratory Factor Analysis (EFA) with 300 prehospital staff. Finally, 34 items related to Biocentric Acting were arranged into 3 factors: 1 – Self-relationship and Communication with Nature; 2 – Relationship to Others; and 3 – Individual Turmoil. Conclusion : This biocentric-acting questionnaire was developed in the Iranian context to assess prehospital staff acting based on the BHMT. It is recommended that this instrument be adopted using BHMT for other occupations and different contexts, to develop a full BHMT scale, especially for workers who have been engaged in the response to the pandemic, in order to assess the consequences of COVID-19.