Lee Geok Ling, Fan Gilbert Kam Tong, Chan Sally Wai Chi
Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Block AS3 Level 4, 3 Arts Link, Singapore, 117570, Singapore.
Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Support Care Cancer. 2015 Dec;23(12):3563-71. doi: 10.1007/s00520-015-2736-3. Epub 2015 Apr 17.
The study aims to examine the psychometric properties of the Holistic Well-Being Scale (HWS), a new instrument developed on the Eastern concepts of affliction, and equanimity in a new sample involving patients with cancer.
A cross-sectional survey was conducted with 300 patients with cancer in Singapore. The patients completed the HWS, WHO-5 Well-Being Index (WHO-5), and Hospital Anxiety and Depressions Scale (HADS). Thirty-two patients participated in the 2-week retest.
Mixed findings were obtained from the original seven-factor model in our sample: six factors had acceptable internal reliabilities (Cronbach's α; range, 0.657-0.809), and construct validities were partially supported. Factor analysis suggested three factors: Blissful-self (α = 0.874), Disturbed-self (α = 0.885) and Embittered-others (α = 0.709). The novel factors demonstrated good test-retest reliability (ICC; range, 0.894-0.930) and construct validities, which were shown by significant correlations with HADS and WHO-5 in the predicted directions.
The present study is the first step taken to validate a scale that is essential in the development of culturally appropriate psychosocial interventions to support and promote personal well-being of cancer patients. The findings suggest that the three-factor model may be more applicable to the Singapore context, but it does not necessarily invalidate the original HWS. The results were discussed in terms of the meaning of the original HWS factors and cultural differences in coping behaviors between Singapore and Hong Kong, though both are Asian countries. The HWS could be further tested in other Asian populations as achieving holistic well-being is a common goal for patients in many cultures.
本研究旨在检验整体幸福感量表（HWS）的心理测量特性，该量表是基于东方的苦恼和平和概念开发的一种新工具，用于一个涉及癌症患者的新样本。
对新加坡300名癌症患者进行了横断面调查。患者完成了HWS、世界卫生组织-5幸福感指数（WHO-5）和医院焦虑抑郁量表（HADS）。32名患者参与了为期2周的重测。
我们样本中最初的七因素模型得出了混合结果：六个因素具有可接受的内部信度（克朗巴哈α系数；范围为0.657 - 0.809），结构效度得到部分支持。因素分析表明有三个因素：幸福自我（α = 0.874）、困扰自我（α = 0.885）和怨愤他人（α = 0.709）。这些新因素显示出良好的重测信度（组内相关系数；范围为0.894 - 0.930）和结构效度，与HADS和WHO-5在预测方向上存在显著相关性，证明了这一点。
本研究是验证该量表的第一步，该量表对于开发符合文化背景的心理社会干预措施以支持和促进癌症患者的个人幸福感至关重要。研究结果表明，三因素模型可能更适用于新加坡的情况，但这并不一定使原来的HWS无效。尽管新加坡和香港都是亚洲国家，但还是根据原来HWS因素的含义以及新加坡和香港在应对行为方面的文化差异对结果进行了讨论。由于实现整体幸福感是许多文化背景下患者的共同目标，因此HWS可在其他亚洲人群中进一步测试。
