Psychometric properties of the Japanese version of the Recovery Attitudes Questionnaire (RAQ) among mental health providers: a questionnaire survey

Abstract

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.

Undergraduate nursing students’ stigma and recovery attitudes during mental health clinical placement: A pre/post‐test survey study

“…Their positive attitudes to recovery improved (P < 0.01) on exit from placement, with consistent understandings of personal recovery also reported in the qualitative data. While there are no prior reports on recovery attitudes of undergraduate nursing students, these findings are generally consistent with the wider literature in mental health, where clinicians' recovery attitudes have been positive prior to recovery education intervention in health services (total score mean = 3.8 to 4.2), and improved further following education (mean = 4.3-4.4) (Chiba et al 2016;Deane et al 2018;Hornik-Lurie et al 2018). There are no prior studies to compare students' written understandings of personal recovery with; however, our qualitative findings indicated that on placement exit, students developed mental health literacy in terms of using more appropriate language to describe personal recovery.…”

“…While there are no prior reports on recovery attitudes of undergraduate nursing students, these findings are generally consistent with the wider literature in mental health, where clinicians’ recovery attitudes have been positive prior to recovery education intervention in health services (total score mean = 3.8 to 4.2), and improved further following education (mean = 4.3–4.4) (Chiba et al . ; Deane et al . ; Hornik‐Lurie et al .…”

Factors related to recovery knowledge and attitudes among professionals in mental health in Japan

“…We conducted a secondary analysis on data from a self‐administered questionnaire survey that was conducted from February to March 2012 (Chiba et al, , ). In the initial study, the sample included mental health professionals from two psychiatric hospitals in the Kanto region and 56 psychiatric clinics and community service agencies in Tokyo, Japan.…”

“…Higher total scores indicate a more positive attitude to the concept of personal recovery. The reliability and validity of the Japanese version of the RAQ were also examined (Cronbach's α = .64; GFI = 0.95; AGFI = 0.90; CFI = 0.86) (Chiba et al, ). The total score of the seven‐item RAQ was used in this study.…”

Reliability and validity of the Japanese version of the INSPIRE measure of staff support for personal recovery in community mental health service users in Japan

“…Additionally, programs aimed toward recovery similar to those developed in the west, such as Assertive Community Treatment, Wellness Recovery Action Plan, Illness Management and Recovery, and Recovery College are widely practiced in Japan [10][11][12][13][14]. For the evaluation of practice, the psychometric properties of the Japanese version of recovery-related scales in which service users measure their personal recovery and service providers measure their recovery knowledge and attitude have been verified [15][16][17][18][19][20]. As described above, programs including personal recovery are being used.…”