1. Kataoka, Mayumi MPH, MBA
  2. Kotake, Risa MHSc
  3. Asaoka, Hiroki MSN
  4. Miyamoto, Yuki PhD
  5. Nishi, Daisuke PhD, MD


Background: Trauma-informed care is recommended to avoid the inadvertent retraumatization of patients by health care providers. Psychometric evaluation of trauma-informed care instruments is needed. The Japanese version of the Attitudes Related to Trauma-Informed Care (ARTIC-10) Scale has not yet been psychometrically validated.


Objective: The study's objective was to examine the reliability and validity of the ARTIC-10.


Methods: This psychometric study of the ARTIC-10 compared with five other scales associated with attitudes related to trauma-informed care used a cross-sectional survey design conducted in November 2020 with a convenience sample of Japanese physicians and nurses recruited from an internet research agency. Participants completed self-administered questionnaires including the (a) ARTIC-10; (b) the Japanese version of the Moral Sensitivity Questionnaire 2018; (c) Patient Health Questionnaire-9; (d) Generalized Anxiety Disorder-7; (e) Stress Underestimation Beliefs; and (f) Negative Acts Questionnaire-Revised. Cronbach's [alpha] measured reliability internal consistency, and construct validity was measured by Spearman's rank.


Results: A total of 794 physicians and nurses completed the surveys. Cronbach's [alpha] value of ARTIC-10 was 0.56. Higher scores of ARTIC-10 were positively and significantly correlated with Moral Sensitivity Questionnaire 2018 and negatively and significantly correlated with other scales (r =-.12 to .30).


Conclusion: This study found only modest internal consistency and construct validity of the Japanese version of ARTIC-10 in physicians and nurses. Further study is needed to identify factors that affect the reliability and validity of this Japanese scale to improve its psychometric properties.