Development and psychometric evaluation of the illustrated hospital fear scale for preschool children.

Hospital-related fear is a significant source of distress for preschool children, yet existing assessment tools are not adequately suited to their developmental level. This methodological study aimed to develop the Illustrated Hospital Fear Scale for Preschool Children and evaluate its psychometric properties. The study was conducted with 300 preschool children aged 4-6 attending educational institutions in western Türkiye. Scale development proceeded through four stages: item generation, expert review, pilot testing and main application. Content validity was assessed using the Davis technique (CVI = 0.892). Exploratory factor analysis revealed a three-factor structure-Diagnosis, Treatment, and Environmental Factors-explaining 57.5% of the total variance. Confirmatory factor analysis demonstrated good model fit (CFI = 0.928, GFI = 0.953, RMSEA = 0.068). Internal consistency was adequate (Cronbach's α = 0.760), and test-retest reliability was strong (r = 0.849, p < 0.001). The scale is a valid and reliable tool for assessing hospital fear in preschool children.