New Persian-Language Questionnaire Puts Nurses’ Professional Identity to the Test

Professional identity — the internalized sense of belonging to, and thinking like, a member of a profession — has long been considered one of the most important outcomes of health professions education. For nurses, it is more than an abstract psychological construct. A strong professional identity is linked to greater commitment to the job, resilience in the face of burnout, adherence to ethical standards, and, critically, staying in the workforce. Yet measuring it reliably across cultures has been a persistent challenge, because questionnaires developed in one language and context do not always behave the same way when translated into another. A new study from Iran, published in BMC Nursing, reports the translation, cultural adaptation, and psychometric evaluation of the Persian version of the Professional Identity Questionnaire (PIQ) among undergraduate nursing students, along with an exploratory application among early-career nurses.

The research team, led by Reyhane Sefidkar, Mahla Kermani, and Fatemeh Keshmiri of Shahid Sadoughi University of Medical Sciences in Yazd, conducted a two-phase cross-sectional study in 2025. Their goal was twofold: first, to establish that a Persian-language PIQ could measure professional identity with acceptable validity and reliability among Iranian nursing students; and second, to see what the instrument reveals when administered to nurses who have recently entered clinical practice. The distinction matters, because the authors are careful to frame the second phase as exploratory rather than as additional validation — a methodological honesty that is often missing from questionnaire studies.

The first phase followed a well-established playbook for cross-cultural instrument adaptation. The researchers translated the PIQ into Persian and culturally adapted it according to Beaton’s guidelines, the standard framework for translating health-status questionnaires. This process is not simple word substitution. It involves forward translation, synthesis, back-translation by independent translators, and review by an expert committee to resolve discrepancies and ensure that each item reads naturally and retains its intended meaning in the target culture. Face validity — whether the items appear to measure what they claim — and content validity — whether they comprehensively cover the construct — were assessed using both qualitative and quantitative approaches. All items met the predefined criteria, meaning the adapted questionnaire passed the first gate of psychometric scrutiny.

The heart of the validation work was structural validity, examined with confirmatory factor analysis (CFA) in a sample of 226 undergraduate nursing students. CFA is a statistical technique that tests whether the pattern of correlations among questionnaire items matches a theoretically predicted structure. In this case, the hypothesized structure was a two-factor model comprising Professional Identity Formation Attachment (PIF-A) and Professional Identity Formation Detachment (PIF-D) — essentially, the degree to which a person bonds with the professional role versus the degree to which they feel detached from it. The results were strikingly good. The model fit indices were excellent: the ratio of chi-square to degrees of freedom was 1.08, the root mean square error of approximation (RMSEA) was 0.01, the comparative fit index (CFI) and incremental fit index (IFI) were both 0.99, the goodness-of-fit index (GFI) was 0.97, and the standardized root mean square residual (SRMR) was 0.04. In practical terms, values of CFI and IFI above 0.95, RMSEA below 0.06, and SRMR below 0.08 are conventionally considered evidence of good fit, and this model comfortably cleared every threshold. Standardized factor loadings — the strength of the relationship between each item and its factor — ranged from 0.30 to 0.90.

Reliability, the consistency of measurement, was assessed in two complementary ways. Internal consistency, which reflects how well items within a scale hang together, was evaluated with Cronbach’s alpha. The total PIQ achieved an alpha of 0.86, generally regarded as good, with the attachment dimension reaching 0.93 — very high — and the detachment dimension at 0.78, which is acceptable for a shorter subscale. Stability over time was tested in an independent sample of 100 nursing students who completed the questionnaire on two occasions, with agreement quantified using the intraclass correlation coefficient (ICC). The total scale achieved an ICC of 0.79 (95% confidence interval: 0.71 to 0.85), which the authors describe as satisfactory. Together, these results indicate that the Persian PIQ produces scores that are both coherent and reasonably stable when the underlying construct has not changed.

With the instrument validated in students, the team turned to the clinical world. In the second phase, the Persian PIQ was administered to a separate sample of 110 early-career nurses to describe their professional identity and examine how it relates to demographic and occupational characteristics. The mean total professional identity score was 38.67 with a standard deviation of 6.77 on a scale where the possible range runs from 10 to 50 — a moderately high average that suggests a generally positive sense of professional identity in this group, though with meaningful individual variation.

The most intriguing finding from the exploratory phase concerned work experience. The number of years worked showed a small positive association with the reverse-scored detachment dimension (r = 0.250, p = 0.008). Because the detachment scale is reverse-scored, this pattern can be read as suggesting that nurses with more work experience reported somewhat less detachment from their professional role — a tentative hint that identity may consolidate with time in practice. In a multiple linear regression analysis, work experience remained positively associated with this dimension (β = 0.250, B = 0.644, 95% CI: 0.164 to 1.125, p = 0.009). However, the authors urge caution, and for good reason: the overall regression model was not statistically significant (R² = 0.063, adjusted R² = 0.037, p = 0.073), meaning the predictors together explained only a small fraction of the variance and the model as a whole did not reach conventional significance. Age and sex were not significantly associated with professional identity outcomes.

The authors are explicit about the limits of their evidence, and their caveats deserve emphasis. The association between work experience and the detachment dimension is modest in magnitude, embedded in a nonsignificant overall model, and derived from a cross-sectional design — a snapshot that cannot establish whether experience causes identity change or whether other unmeasured factors drive the pattern. Furthermore, the exploratory application among early-career nurses provided descriptive and associative evidence but did not constitute additional psychometric validation; the reliability and validity findings formally apply to the student sample in which they were established. The researchers also note that further validation in larger and more diverse nursing populations is warranted, including formal measurement-invariance testing — a procedure that verifies whether a questionnaire measures the same construct in the same way across different groups — and additional sources of validity evidence before the instrument is used for broad comparisons or intervention studies.

Why does this matter beyond the statistics? Nursing systems worldwide face chronic shortages and high early-career attrition, and professional identity is increasingly viewed as a protective factor that helps newly qualified nurses weather the difficult transition from classroom to ward. A validated Persian-language instrument gives Iranian educators, hospital administrators, and researchers a practical tool to track how identity forms during training and how it holds up in the first years of practice. It also opens the door to cross-cultural research, allowing findings from Iran to be compared with those from other countries once equivalent validated versions exist. The study, funded by Shahid Sadoughi University of Medical Sciences and approved by its ethics committee, with written informed consent obtained from all participants, was published open access on 13 October 2026 in BMC Nursing under DOI 10.1186/s12912-026-05497-9. As the first rigorously validated Persian version of the PIQ, it represents a small but concrete step toward understanding — and ultimately strengthening — the professional self that nurses carry with them from their first lecture to their thousandth shift.

Subject of Research: Psychometric validation of the Persian Professional Identity Questionnaire among nursing students and early-career nurses

Article Title: Psychometric validation and exploratory application of the Professional Identity Questionnaire (PIQ) among nursing students and early-career nurses

Article References: Psychometric validation and exploratory application of the Professional Identity Questionnaire (PIQ) among nursing students and early-career nurses. (n.d.). https://doi.org/10.1186/s12912-026-05497-9

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05497-9

Keywords: professional identity, psychometrics, questionnaire validation, nursing education, confirmatory factor analysis, cross-cultural adaptation, early-career nurses, reliability, BMC Nursing, Iran, workforce retention, measurement invariance