Background“Recovery” is a central concept in mental health, particularly for mental health services and policy-makers. The present study examined the factorial and concurrent validity, internal consistency reliability, and test–retest reliability of the Japanese version of the 7-item Recovery Attitudes Questionnaire (RAQ) among mental health service providers in community and inpatient settings in Japan.MethodsWe conducted a cross-sectional questionnaire with a number of eligible professional groups, including psychiatrists, registered/assistant nurses, public health nurses, clinical psychologists, pharmacists, occupational therapists, and social workers. Participants were drawn from two psychiatric hospitals and 56 psychiatric clinics or community service agencies. In total, 331 participants completed the questionnaire. After excluding those with missing RAQ values, 307 participants were included in the analysis; the participants’ mean age was 40.2 years and 29.6 % were men. The questionnaire comprised the Japanese version of the 7-item RAQ developed by the present authors, the revised scale of the positive attitudes of staff toward persons with mental disorder (the positive attitudes scale), and the Japanese-language version of the Social Distance Scale (SDSJ). Confirmatory factor analyses were used to examine factorial validity of a two-factor structure reported in a previous study (Borkin et al., 2000) as well as a single-factor structure. Concurrent validity was determined by calculating correlations between RAQ and the other two scales. Internal consistency reliability was assessed with Cronbach’s alpha coefficients and inter-item correlations. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC), with a weighted kappa in a subsample of participants (n = 13).ResultsThe two-factor structure showed acceptable factorial validity. RAQ scores were significantly and positively correlated with the positive attitudes scale, and there was a significant inverse correlation with the SDSJ (p < 0.01). The RAQ had an overall Cronbach’s alpha coefficient of 0.64. Four inter-item correlations were not significant. The ICC and weighted kappa values indicated unsatisfactory test–retest reliability.ConclusionThe Japanese RAQ showed acceptable factorial validity, reasonable concurrent validity, and unsatisfactory reliability in community and inpatient mental health settings in Japan. Further large-scale research is required to ensure robust verification.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0740-x) contains supplementary material, which is available to authorized users.

BackgroundThe Recovery Knowledge Inventory (RKI) is one of the influential scales to assess knowledge and attitude toward recovery-oriented practices among mental health service providers. In the present study, we aimed to develop a Japanese version of RKI and examine the validity and reliability.MethodsWe translated RKI into Japanese by reference to the guidelines for translating and adapting psychometric scales. A cross-sectional questionnaire survey was conducted with mental health service providers. Of a total of 475 eligible professionals, we used data from the 299 participants without missing value for the analyses (valid response rate = 62.9%). The questionnaire included Japanese RKI, Recovery Attitudes Questionnaire, The positive attitudes scale, and Japanese-language version of the Social Distance Scale. To examine the factorial validity of RKI, explanatory factor analysis and confirmatory factor analysis was employed. Convergent validity was assessed by calculating Pearson’s correlation coefficients between the total RKI score and the scores for the other three scales. We also calculated Cronbach’s α coefficients for the total score and for each domain of RKI to assess internal consistency reliability.ResultsThe participants’ mean age was 40.4 years and 30.4% were men. 20-item RKI did not provide any adequate or interpretable factor solutions at any number of factors by EFAs. Thus four items (#1, 4, 5, and 13) were subsequently eliminated in stages, then 16-item RKI was employed as a consequence for further analyses. EFA with four factor structures yielded marginally interpretable constitution. Each factor represented the knowledge regarding psychiatric symptoms and recovery; knowledge about the recovery process; the understanding of what is important for recovery; and the understanding of the challenges and responsibility in recovery, respectively. Subsequent CFA suggested good fit to the data. Good convergent validity and understandable internal consistency reliability were also observed.ConclusionsThe Japanese 16-item RKI revealed reasonable factorial validity, good convergent validity, and understandable internal consistency reliability among mental health professionals. Japanese cultural settings seemed to influence the four-factor structure in the present study. It can be used for future study in Japan, while future large-scale research is required to ensure robust verification.

Aim To explore what factors may influence recovery knowledge and attitudes among professionals in mental health. Methods We utilized an existing dataset from a study that surveyed 331 subjects among 475 eligible professionals. We used data from 289 participants without missing values for the analyses (valid response rate = 60.8%). The questionnaire included three psychometrically tested scales: (a) Recovery Knowledge Inventory (RKI); (b) Recovery Attitudes Questionnaire (RAQ); and (c) Internal Work Motivation, as well as other variables. Mean‐based comparisons of the RKI and RAQ scores between several subgroups were examined. We also examined the correlation between RKI and RAQ scores and the continuous variables. Multiple linear regression was implemented to examine the simultaneous effects of the factors on RKI and RAQ scores. The mean age of participants was 39.9 years and 69.2% were female and 44.0% were nursing professionals. Results Multiple linear regression analyses showed that the internal work motivation and the experience of discharging patients after a lengthy hospitalization were significantly and positively associated with recovery attitude. Working at community facilities and being young were significantly and weakly correlated with recovery knowledge. The experience of participation in self‐help groups exhibited positive relationships with RKI and RAQ scores, while education exhibited positive but weak relationships with RKI and RAQ scores. No significant relationship was observed in the regression analyses. Conclusions Internal work motivation, the experience of discharging patients after a lengthy hospitalization, working at community facilities, and being young may positively contribute to better recovery knowledge and attitudes. Future research using a longitudinal design will explore other factors.

This study aimed to examine the association between control over practice in work environments and stigma toward people with schizophrenia among mental health professionals. We conducted secondary analyses on data from a self-administered questionnaire survey. The sample in the initial study included mental health professionals from two psychiatric hospitals, 56 psychiatric clinics, and community service agencies in Japan. The Ethics Committee of the University of Tokyo, approved this study. Data from 279 participants were used for secondary analyses (valid response rate = 58.7%). The hierarchical multiple regression analysis was used to determine the association between control over practice and stigma. We performed subgroup analyses among nurses (n = 121) and psychiatric social workers (n = 92). Control over practice was negatively associated with stigma among mental health professionals (β = −0.162, p < 0.01). The subgroup analyses among nurses indicated that control over practice, educational history and recovery knowledge were associated with stigma. However, these variables were not associated with stigma among psychiatric social workers. Control over practice might help to reduce stigma among mental health professionals. Factors related to stigma might differ by occupation. Therefore, further comprehensive studies among various professionals would further our understanding of these factors.

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