Assessing the psychological factors associated with vaccine hesitancy: psychometric properties of the psychological factors in healthcare behavior questionnaire (PF-HBQ)

Introduction Health-related decision-making is influenced by a complex interplay of cognitive, emotional, and personality-related factors. Psychological characteristics such as distress, personality traits, and maladaptive cognitive patterns play a central role in shaping how individuals perceive medical information, engage with healthcare systems, and adhere to health-related recommendations. Understanding these determinants is essential for clarifying individual differences in healthcare behaviors and for informing effective interventions in clinical and public health contexts. The present research introduces the Psychological Factors in Healthcare Behavior Questionnaire (PF-HBQ), a novel instrument designed to assess psychological dimensions relevant to healthcare-related decision-making. Overall, the PF-HBQ was developed to capture individual differences in psychological functioning that may influence attitudes and behaviors in medical contexts. Methods The research was conducted through two studies. In Study 1, the psychometric properties of the questionnaire were evaluated on a large sample of individuals (N=472, 149 males, aged 18-86 years) by performing confirmatory and exploratory factor analysis, assessing test-retest reliability and convergent and divergent validity. In Study 2, differences in psychological factors between vaccine hesitant vs. non-hesitant individuals were explored in a further sample of participants (N=192, 47 males aged 18-71 years). Results The results showed that the PF-HBQ questionnaire is a reliable and comprehensive tool for assessing 9 psychological factors (Suspiciousness, General Distress, Extraversion, Openness, Procrastination, Depressive Symptoms, Post-Traumatic Symptoms, Obsessive-Compulsive Traits, Emotional Stability) relevant to healthcare decision-making and shaping health-related attitudes and behaviors, including vaccination-related decision-making. Discussion These findings may contribute to a deeper understanding of psychological influences on healthcare engagement and support the development of tailored public health strategies.