Nahar-van Venrooij Lenny M W, Metz Margot J, van Vliet Marja, van Druten Vera P, van der Zwaard Babette C
Jeroen Bosch Academy Research, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands
Tranzo Scientific Centre for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands.
BMJ Open. 2025 Mar 24;15(3):e091377. doi: 10.1136/bmjopen-2024-091377.
This study aimed to further develop and cross-validate a short questionnaire to measure self-reported Positive Health in general (Dutch) populations for evaluative purposes, stemming from the original 42 items of the My Positive Health (MPH) dialogue tool. Positive Health refers to 'health from the perspective of patients and citizens' following the concept of Huber .
A cross-sectional study was performed among a panel representative for the general adult Dutch population living at home.
The response rate was 76%, 1327 of a total of 2457 respondents were female, and mean age (years) was 53.3±17.8.
First, item reduction was carried out through content discussions following statistical output retrieved from factor structures and loadings, inter-item correlations and internal consistency (Cronbach's alpha). Next, among the other half of the study population, measurement properties for the developed short questionnaire were calculated using goodness of fit indices from confirmatory factor analysis (CFA).
The item reduction process (n=1199) resulted in a questionnaire of 22 items (PH22) with a four-factor structure and explained variance of 62.4%. Cronbach's alpha values were 0.84, 0.92, 0.81 and 0.78 for the renamed factors 'Physical fitness' (5 items), 'Contentment with self, others and life' (nine items), 'Daily life management' (5 items) and 'Future perspective' (3 items), respectively. Cross-validation (n=1258) showed adequate goodness-of-fit indices of the PH22, based on both first-order and second-order CFA. The scores of the PH22 were normally distributed. No floor or ceiling effects were present.
A short 22-item questionnaire to measure self-reported Positive Health in a general (Dutch) population for evaluative purposes such as scientific or policy research at Positive Health or patient-centred interventions was developed and cross-validated, named PH22. This study supports its structural validity. To use this questionnaire in practice, its test-retest reliability and responsiveness should also be known. Future research has to reveal this.
本研究旨在进一步开发并交叉验证一份简短问卷，以评估一般（荷兰）人群自我报告的积极健康状况，该问卷源自最初包含42个条目的“我的积极健康”（MPH）对话工具。根据休伯的概念，积极健康是指“从患者和公民角度出发的健康”。
对代表荷兰居家成年普通人群的一个小组进行了一项横断面研究。
回复率为76%，在总共2457名受访者中，1327名是女性，平均年龄为53.3±17.8岁。
首先，根据从因子结构和载荷、项目间相关性及内部一致性（克朗巴哈α系数）得出的统计结果，通过内容讨论进行项目精简。接下来，在研究人群的另一半中，使用验证性因子分析（CFA）的拟合优度指标计算所开发简短问卷的测量属性。
项目精简过程（n = 1199）产生了一份包含22个条目的问卷（PH22），具有四因子结构，解释方差为62.4%。重新命名的因子“身体健康”（5个条目）、“对自己、他人和生活的满足感”（9个条目）、“日常生活管理”（5个条目）和“未来展望”（3个条目）的克朗巴哈α系数分别为0.84、0.92、0.81和0.78。交叉验证（n = 1258）表明，基于一阶和二阶CFA，PH22具有足够的拟合优度指标。PH22的得分呈正态分布。不存在地板效应或天花板效应。
开发并交叉验证了一份包含22个条目的简短问卷，用于评估一般（荷兰）人群自我报告的积极健康状况，以用于积极健康或以患者为中心干预措施的科学或政策研究等评估目的，命名为PH22。本研究支持其结构效度。要在实践中使用该问卷，还应了解其重测信度和反应度。未来研究必须揭示这一点。
