Chen Hanhui, Wang Zhizhong, Phillips Michael Robert
Shanghai Jiao Tong University School of Medicine.
105002 Ningxia Medical University.
Transcult Psychiatry. 2018 Feb;55(1):94-119. doi: 10.1177/1363461517748847. Epub 2017 Dec 21.
To assess the effectiveness of China's recent moves to increase community mental health literacy and decrease stigma, we developed the Mental Health Knowledge Questionnaire (MHKQ) and the Mental Health Attitude Questionnaire (MHAQ). Preliminary versions were assessed in pilot studies and revised versions were included in an interviewer-administered community survey of a representative sample of 2425 adult residents of Ningxia Province and a re-test survey in 188 individuals. Internal consistency, factor structure and test-retest reliability were assessed for three measures: (a) the 25-item MHKQ (alpha = .71, 6 factors accounting for 51% of variance identified in exploratory factor analysis of one-half of the sample, and intraclass correlation coefficient [ICC] for total score of .40); (b) the 14-item attitudinal subscale of MHAQ (alpha = .69, 3 factors accounting for 42% of variance, ICC = .47); and (c) the 7-item causal attribution subscale of MHAQ (alpha = .60, 3 factors accounting for 60% of variance, ICC = .26). Confirmatory factor analysis assessed fitness of modified models of the measures using chi-squared, comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA): (a) for the MHKQ, RMSEA = .037 (90% CFI = .033, .040), CFI = .86, TLI = .84, χ = 682.86 (df = 260); (b) for the attitudinal subscale of MHAQ, RMSEA = .045 (CI = .039, .052), CFI = .94, TLI = .92, χ = 226.67 ( df = 66); and (c) for the causal attribution subscale of MHAQ, RMSEA = .054 (.039, .069), CFI = .97, TLI = .94, χ = 49.13 ( df = 11). We conclude that the internal consistency and factor structure of the new measures are satisfactory, but further work is needed to improve the scales' stability and to assess the construct validity and responsiveness of the scales.
为评估中国近期提高社区心理健康素养及减少污名化举措的有效性，我们编制了心理健康知识问卷（MHKQ）和心理健康态度问卷（MHAQ）。初步版本在试点研究中进行了评估，修订版本被纳入一项由访员实施的社区调查，该调查选取了宁夏回族自治区2425名成年居民的代表性样本，并对188人进行了重测调查。对三项指标评估了内部一致性、因子结构和重测信度：（a）25题的MHKQ（α = 0.71，在对样本一半进行探索性因子分析时确定的6个因子解释了51%的方差，总分的组内相关系数[ICC]为0.40）；（b）MHAQ的14题态度分量表（α = 0.69，3个因子解释了42%的方差，ICC = 0.47）；（c）MHAQ的7题因果归因分量表（α = 0.60，3个因子解释了60%的方差，ICC = 0.26）。验证性因子分析使用卡方、比较拟合指数（CFI）、塔克 - 刘易斯指数（TLI）和近似误差均方根（RMSEA）评估了这些指标修正模型的拟合度：（a）对于MHKQ，RMSEA = 0.037（90%CI = 0.033，0.040），CFI = 0.86，TLI = 0.84，χ = 682.86（自由度 = 260）；（b）对于MHAQ的态度分量表，RMSEA = 0.045（CI = 0.039，0.052），CFI = 0.94，TLI = 0.92，χ = 226.67（自由度 = 66）；（c）对于MHAQ的因果归因分量表，RMSEA = 0.054（0.039，0.069），CFI = 0.97，TLI = 0.94，χ = 49.13（自由度 = 11）。我们得出结论，新指标的内部一致性和因子结构令人满意，但需要进一步开展工作以提高量表的稳定性，并评估量表的结构效度和反应度。
