Department of Social Sciences and Health Policy, Wake Forest School of Medicine & The Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Qual Life Res. 2020 Aug;29(8):2299-2310. doi: 10.1007/s11136-020-02489-3. Epub 2020 Apr 19.
A sense of meaning and purpose is important for people living with acute and chronic illness. It can buffer the effects of stress and facilitate adaptive coping. As part of the Patient-Reported Outcomes Measurement Information System (PROMIS), we developed and validated an item response theory (IRT)-based measure of meaning and purpose in life.
Informed by a literature review and patient and content-expert input, we wrote 52 items to assess meaning and purpose and administered them to a general population sample (n = 1000) along with the Meaning in Life Questionnaire-Presence of Meaning Subscale (MLQ-Presence) and the Life Engagement Test (LET). We split the sample in half for exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA). IRT analyses included assessments of differential item functioning (DIF).
Participants had a mean age of 47.8 years and 50.3% were male. EFA revealed one dominant factor and CFA yielded a good fitting model for a 37-item bank (CFI = 0.962, TLI = 0.960, RMSEA = 0.085). All items were free of sex, age, education, and race DIF. Internal consistency reliability estimates ranged from α = 0.90 (4-item short form) to α = 0.98 (37-item bank). The 8-item Meaning and Purpose short form was correlated with the MLQ-Presence (r = 0.89), the LET (r = 0.79), and the full PROMIS Meaning and Purpose item bank (r = 0.98).
The PROMIS Meaning and Purpose measures demonstrated sufficient unidimensionality and displayed good internal consistency, model fit, and convergent validity. Further psychometric testing of the PROMIS Meaning and Purpose item bank and short forms in people with chronic diseases will help evaluate the generalizability of this new tool.
对患有急性和慢性疾病的人来说，意义感和目标感很重要。它可以缓冲压力的影响，并促进适应性应对。作为患者报告的结果测量信息系统（PROMIS）的一部分，我们开发并验证了一种基于项目反应理论（IRT）的生活意义和目标感测量方法。
根据文献回顾以及患者和内容专家的意见，我们编写了 52 个项目来评估意义感和目标感，并将其与生活意义问卷-存在意义子量表（MLQ-Presence）和生活参与度测试（LET）一起分发给一般人群样本（n=1000）。我们将样本一分为二，进行探索性因素分析（EFA），然后进行验证性因素分析（CFA）。IRT 分析包括差异项目功能（DIF）的评估。
参与者的平均年龄为 47.8 岁，50.3%为男性。EFA 显示出一个主要因素，CFA 为一个 37 项的银行模型提供了良好的拟合度（CFI=0.962，TLI=0.960，RMSEA=0.085）。所有项目均无性别、年龄、教育和种族 DIF。内部一致性信度估计值范围从α=0.90（4 项简短形式）到α=0.98（37 项银行）。8 项意义和目标简短形式与 MLQ-Presence（r=0.89）、LET（r=0.79）和完整的 PROMIS 意义和目标项目库（r=0.98）相关。
PROMIS 意义和目标测量方法具有足够的单维性，表现出良好的内部一致性、模型拟合度和收敛效度。在患有慢性疾病的人群中进一步测试 PROMIS 意义和目标项目库和简短形式，将有助于评估该新工具的普遍性。
