Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-0033, Japan.
Int J Nurs Stud. 2010 Mar;47(3):314-22. doi: 10.1016/j.ijnurstu.2009.07.006. Epub 2009 Aug 12.
BACKGROUND: Recovery is defined as a complex process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. To promote this process, the necessity of recovery assessment using psychometric measures has been emphasized; however, no measure to assess the individual recovery process is available in Japan. OBJECTIVE: To develop a Japanese version of the Recovery Assessment Scale (RAS) and to examine its reliability and validity. DESIGN: The study was a cross-sectional questionnaire survey. SETTINGS: Participants came from 1 daycare, 1 outpatient clinic of a psychiatric hospital, 5 sheltered workshops used for social rehabilitation, 3 peer support groups, and 6 inpatient wards of 2 psychiatric hospitals. PARTICIPANTS: The survey included 237 participants who had chronic mental illness and were aged 20 or older. For analysis, we used data from 209 participants who had no missing values on the RAS, with 58.9% male and a mean age of 48.3 years. METHODS: The questionnaire consisted of the Japanese version of the 24-item RAS, developed by the authors with focus group cognitive interviews and the translation-back-translation procedure. Also included were the Herth Hope Index, Empowerment scale, Resilience scale, SF-8, and BASIS-32. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and weighted kappa in a randomly selected subsample (n=24). Exploratory and confirmatory factor analyses and correlations with other scales were used to examine the factor-based validity, concurrent and construct validity of the RAS. RESULTS: Cronbach's alpha coefficient was 0.89 for the overall RAS. ICC and weighted kappa generally indicated good test-retest reliability. Factor analysis of the RAS items yielded five factors: (a) goal/success orientation and hope, (b) reliance on others, (c) personal confidence, (d) no domination by symptoms, and (e) willingness to ask for help. The item "Coping with mental illness is no longer the main focus of my life" showed an inverse factor loading. The overall RAS score significantly and positively correlated with the Herth Hope Index, Empowerment scale, Resilience scale, and SF-8 mental component summary; there was a significant negative correlation with BASIS-32 psychiatric symptoms and functional impairment (p<0.01). CONCLUSION: This study confirmed the reliability and validity of the Japanese version of the 24-item RAS among people with chronic mental illness currently living in communities and inpatient ward settings in Japan.
背景:恢复被定义为一个复杂的过程,即一个人在从精神疾病的灾难性影响中恢复过来后,重新找到生活的意义和目标。为了促进这一过程,使用心理测量学方法评估恢复情况的必要性已经得到强调;然而,在日本还没有评估个体恢复过程的测量工具。
目的:开发恢复评估量表(RAS)的日语版,并检验其信度和效度。
设计:本研究是一项横断面问卷调查。
地点:参与者来自 1 家日间护理中心、1 家精神病院的门诊、5 家用于社会康复的庇护性工作坊、3 个同伴支持小组和 2 家精神病院的 6 个住院病房。
参与者:该调查共纳入 237 名患有慢性精神疾病且年龄在 20 岁及以上的参与者。在分析中,我们使用了来自 209 名无 RAS 缺失值的参与者的数据,其中 58.9%为男性,平均年龄为 48.3 岁。
方法:问卷包括作者通过焦点小组认知访谈和翻译-回译程序开发的 24 项 RAS 的日语版。还包括 Herth 希望指数、赋权量表、韧性量表、SF-8 和 BASIS-32。内部一致性信度通过 Cronbach's alpha 系数进行评估,在随机选择的子样本(n=24)中通过组内相关系数(ICC)和加权kappa 进行重测信度评估。通过探索性和验证性因子分析以及与其他量表的相关性来检验 RAS 的因子结构效度、同时效度和构念效度。
结果:RAS 的整体 Cronbach's alpha 系数为 0.89。ICC 和加权 kappa 通常表明重测信度良好。RAS 项目的因子分析产生了五个因子:(a)目标/成功导向和希望,(b)依赖他人,(c)个人信心,(d)不受症状支配,(e)愿意寻求帮助。“应对精神疾病不再是我生活的主要焦点”这一项目呈现出反向因子负荷。RAS 的总分与 Herth 希望指数、赋权量表、韧性量表和 SF-8 心理成分综合得分显著正相关;与 BASIS-32 精神病症状和功能障碍显著负相关(p<0.01)。
结论:本研究在日本社区和住院病房环境中,确认了慢性精神疾病患者使用的 24 项 RAS 日语版的信度和效度。
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