Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore.
Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.
BMC Med Res Methodol. 2018 Mar 15;18(1):29. doi: 10.1186/s12874-018-0487-9.
Measures of mental well-being and positive mental health (PMH) have been largely developed and used in Western populations, however, data on representative Asian communities are lacking. Using data from a population sample, this study sought to establish psychometric properties and norms of the PMH Instrument (PMH-I), a measure of positive mental health developed in Singapore.
We conducted a nationally representative survey among 1925 adults aged 18-79 years of Chinese, Malay, Indian or other ethnicity. Participants reported socio-demographic characteristics and completed the PMH-I along with measures of health-related quality of life (HRQoL) and psychological distress. Construct validity of the PMH-I was assessed using confirmatory factor analysis and concurrent validity was tested through correlation with other psychological measures. Normative PMH values and differences in population subgroups were estimated.
The six-factor-higher-order structure of the PMH-I comprising six subscales of general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy and global affect was confirmed. Concurrent validity was shown through significant positive correlation of the total PMH score and its subscales with HRQoL and an inverse correlation with psychological distress. Weighted age, gender and ethnicity-specific norms were derived for the Singapore population. Total PMH was significantly higher in participants aged over 40 years as compared with 18-29 year olds and in non-Chinese ethnic groups as compared with Chinese. These differences were observed for all PMH-I subscales, with the exception of emotional support and interpersonal skills score differences by age. In contrast, gender, marital status, and education level were significantly associated with some of the subscales, but not with total PMH.
These results support the psychometric properties of the PMH-I in a multi-ethnic Asian population sample. The generalizable population-based norms support the application of the PMH-I for measuring mental health and assessing its determinants within the Singapore general population.
心理健康和积极心理健康的衡量标准在很大程度上是在西方人群中开发和使用的，然而，缺乏代表亚洲社区的数据。本研究使用来自人口样本的数据，旨在建立新加坡开发的积极心理健康衡量标准——心理健康量表（PMH-I）的心理测量学特性和常模。
我们对 1925 名年龄在 18-79 岁的中国、马来、印度或其他族裔的成年人进行了全国代表性调查。参与者报告了社会人口统计学特征，并完成了 PMH-I 以及与健康相关的生活质量（HRQoL）和心理困扰的衡量标准。通过验证性因子分析评估 PMH-I 的结构效度，并通过与其他心理测量的相关性来检验其同时效度。估计了 PMH 的规范值和人群亚组之间的差异。
PMH-I 的六因素高阶结构，包括一般应对、情感支持、灵性、人际交往技巧、个人成长和自主以及整体情感六个分量表得到了确认。通过 PMH 总分及其分量表与 HRQoL 呈显著正相关，与心理困扰呈负相关，显示出同时效度。为新加坡人口得出了加权年龄、性别和种族特异性的常模。与 18-29 岁的年轻人相比，40 岁以上的参与者以及非华族群体的总 PMH 明显更高。除了年龄的情绪支持和人际交往技巧评分差异外，所有 PMH-I 分量表都观察到了这些差异。相比之下，性别、婚姻状况和教育水平与一些分量表显著相关，但与总 PMH 无关。
这些结果支持 PMH-I 在多民族亚洲人群样本中的心理测量特性。可推广的基于人群的常模支持在新加坡一般人群中使用 PMH-I 来衡量心理健康，并评估其决定因素。
