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The Construct of the Schizophrenia Quality of Life Scale Revision 4 for the Population of Taiwan 时间:2017-07-22 23:00 来源:未知作者:admin 点击: 次 Abstract:This study examines the factor structure of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) for inpatients with schizophrenia in a psychiatric hospital in southern Taiwan. All the participants (n=100) filled out the SQLS-R4, Mini Mental Status Examination (MMSE), and Brief Psychiatric Rating Scale (BPRS) under the supervision of one experienced occupational therapist. Using confirmatory factor analysis, we first determined that a 29-item model was more satisfactory than the original 33-item model based on the findings of better fit indices for the 29-item model. We then found that a three-correlated-factor structure was best for the SQLS-R4 after four models (namely, two-correlated-factor, three-correlated-factor, seven-correlated-factor, and second-order models) had been compared. In addition, the three constructs (psychosocial, physical, and vitality) were moderately to highly correlated with the constructs of the World Health Organization Quality of Life- (WHOQOL-) BREF ( to ), except for one low correlation between the vitality construct of the SQLS-R4 and the psychological construct of the WHOQOL-BREF (). We tentatively conclude that the SQLS-R4 with a three-correlated-factor structure is a valid and reliable instrument for examining the quality of life of people with schizophrenia.
1. Introduction
Quality of life (QoL) measures have become more important for therapeutic interventions and clinical decisions [1, 2], especially for patients with chronic illness [3]. When people with schizophrenia confront their chronic disabling illness, it is important for healthcare professionals to understand their QoL. QoL, a subjective perception of an individual’s health position within their cultural context and value system [4], can be used as one of the long-term goals of medical interventions [3].
Two kinds of QoL measures can be applied to people with schizophrenia: generic QoL measures and schizophrenia-specific QoL measures [5]. Although the schizophrenia-specific QoL measures cannot compare QoLs between different populations with disabilities (e.g., people with stroke and people with spinal cord injury), they focus on the core symptoms that people with schizophrenia encounter [5]. Therefore, the schizophrenia-specific QoL measures are particularly useful for understanding how the symptoms affect the QoL of people with schizophrenia.
Several schizophrenia-specific QoL measures have been developed, and the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) has been suggested to be one of the most useful ones [5–7]. In addition to its items specifically designed for people with schizophrenia [5, 8], its other strengths include (1) practical and short content to fill out (10–15 minutes to complete); (2) improved psychometric properties after several revisions [6, 9]; (3) solid factor structure and internal reliability [7–12]; and (4) availability of cross-cultural comparisons by providing rigorously translated versions in 52 languages through standardized procedures: forward translation, reconciliation, and back translation [9].
However, as a newly developed QoL measure [8, 11], the construct of SQLS-R4 still needs to be confirmed. Although the SQLS-R4 has good psychometric properties [6, 10, 13], to the best of our knowledge, only one UK study [7] has used confirmatory factor analysis (CFA) to examine the construct of SQLS-R4. The advantage of using CFA is being able to compare several proposed models and to clarify the construct of the tested instruments [14]. Therefore, the CFA is suitable for understanding the constructs of measurements that are under development, such as the SQLS-R4. Although the SQLS-R4 was suggested to be two-dimensional [6, 7, 12, 13], Martin and Allan [7] indicated that some CFA fit indices are not acceptable (root mean square error of approximation [RMSEA] = 0.11 and weighted root mean square residual [WRMR] = 0.94). In addition, one Singaporean study [11] mentions that the cultural difference between Asia and the West may influence the psychometric properties of the SQLS-R4. Thus, the construct of the SQLS-R4 may differ in Asian and Western cultures. Therefore, for better application and interpretation of the SQLS-R4, we suggest that additional studies on the SQLS-R4 construct in Asian populations are needed.