Cross cultural evaluation of the Warwick-Edinburgh mental well-being scale (WEMWBS) -a mixed methods study
Tóm tắt
We aimed to validate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) among English speaking adults representing two of the minority ethnic groups living in the UK, self-identified as Chinese or Pakistani by background, in a mixed methods study. Quantitative data were collected in two cities in the West Midlands, UK. Item response, dimensionality, internal consistency, and construct validity of the WEMWBS were assessed in Chinese and Pakistani groups separately, using data from both cities combined. Qualitative data were collected in the first city in eight focus groups of different ages recruited by the community workers. Three mixed sex Chinese and five single sex Pakistani groups discussed ease of completion and comprehension of items, together with overall reactions to the scale and underlying concept. Results of quantitative and qualitative analysis were examined for commonalities and differences. Item completion and item total correlations were satisfactory in both groups. In the Chinese data, Exploratory Factor Analysis showed a single factor with loadings ranging from 0.60 to 0.82 for all 14 items. In the Pakistani data, three factors reached statistical significance; however, a substantial drop in eigenvalues between the first and second factors and the limited variance explained by the second and third factors supported a one-factor model. All items loaded on this factor from 0.51 to 0.83. In the Chinese and Pakistani data respectively, Cronbach’s alpha was 0.92 (0.89 – 0.94) and 0.91 (0.88 – 0.94); Spearman’s correlation with GHQ-12 was - 0.63 (−0.73 to −0.49) and −0.55 (−0.70 to −0.36), and with the WHO-5 0.62 (0.46-0.75) and 0.64 (0.50 to 0.76). Qualitative analysis revealed good comprehension and ease of completion of almost all items. Some culturally determined differences in understanding of mental well-being, which varied both between and within communities, emerged. The WEMWBS was well received by members of both Pakistani and Chinese communities. It showed high levels of consistency and reliability compared with accepted criteria. Data were sufficiently strong to recommend the WEMWBS for use in general population surveys.
Tài liệu tham khảo
HM Government Department of Health: No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages. 2011. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124058.pdf
The Scottish Government: Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009–2011. 2009. http://www.scotland.gov.uk/Publications/2009/05/06154655/0
WHO: Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organisation; 2004.
Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S: The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 2007,5(1):63. 10.1186/1477-7525-5-63
Lloyd K, Devine P: Psychometric properties of the Warwick-Edinburgh mental well-being scale (WEMWBS) in Northern Ireland. J Ment Health 2012,21(3):257–263. 10.3109/09638237.2012.670883
Clarke A, Friede T, Putz R, Ashdown J, Martin S, Blake A, Adi Y, Parkinson J, Flynn P, Platt S, Stewart-Brown S: Warwick-Edinburgh mental well-being scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment. BMC Public Health 2011,11(1):487. 10.1186/1471-2458-11-487
Maheswaran H, Weich S, Powell J, Stewart-Brown S: Evaluating the responsiveness of the Warwick Edinburgh mental well-being scale (WEMWBS): group and individual level analysis. Health Qual Life Outcomes 2012,10(1):156. 10.1186/1477-7525-10-156
Crawford MJ, Robotham D, Thana L, Patterson S, Weaver T, Barber R, Wykes T, Rose D: Selecting outcome measures in mental health: the views of service users. Journal of Mental Health 2011,20(4):336–346. 10.3109/09638237.2011.577114
Prior L, Chun PL, Huat SB: Beliefs and accounts of illness. Views from two Cantonese-speaking communities in England. Sociology of Health & Illness 2000,22(6):815–839. 10.1111/1467-9566.00232
Hussain N: Culturally determined care goals and the efficacy of statutory services. International Journal of Qualitative Studies on Health and Well-Being 2006,1(3):149–158. 10.1080/17482620600756080
Tabassum R, Macaskill A, Ahmad I: Attitudes towards mental health in an urban Pakistani community in the United Kingdom. International Journal of Social Psychiatry 2000,46(3):170–181. 10.1177/002076400004600303
Sonuga-Barke EJ, Mistry M: The effect of extended family living on the mental health of three generations within two Asian communities. British Journal of Clinical Psychology 2000,39(2):129–141. 10.1348/014466500163167
Newbigging K, Bola M, Shah A: Scoping exercise with Black and minority ethnic groups on perceptions of mental wellbeing in Scotland. Scotland: NHS Health; 2008. http://www.healthscotland.com/documents/2803.aspx
Collins G, Johnson MRD Report NIHR Health Technology Assessment. Addressing Ethnic Diversity In Health Outcome Measurement: A Systematic and Critical Review of the Literature 2009. http://www2.warwick.ac.uk/fac/med/research/csri/ethnicityhealth/research/ethtom_final_draft.pdf
Christopher JC, Hickinbottom S: Positive psychology, ethnocentrism, and the disguised ideology of individualism. Theory & Psychology 2008,18(5):563–589. 10.1177/0959354308093396
Statistics Office for National: 2011 Census, Key Statistics for Local Authorities in England and Wales. 2013. http://www.ons.gov.uk/ons/rel/census/2011-census/key-statistics-for-local-authorities-in-england-and-wales/index.html
Khalifa N, Hardie T: Possession and jinn. J R Soc Med 2005,98(8):351–353. 10.1258/jrsm.98.8.351
Saamah A, Sagar S: Well-being patterns uncovered. An analysis of UK data. New Economics foundation 2012. http://www.neweconomics.org/sites/neweconomics.org/files/Unlocking_wellbeing_webReady.pdf
Goldberg D, Williams P: A user’s guide to the general health questionnaire. Windsor,UK: NFER-Nelson; 1988.
Henkel V, Mergl R, Kohnen R, Maier W, Möller H, Hegerl U: The WHO-5 wellbeing index performed the best in screening for depression in primary care. Evidence Based Medicine 2003,8(5):155. 10.1136/ebm.8.5.155
Bech P, Olsen RL BP, Kjoller M, Rasmussen NK: Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 mental health subscale and the WHO-five well-being scale. Int J Meth Psychiatr Res 2003,12(2):85–91. 10.1002/mpr.145
Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ: Evaluating the Use of exploratory factor analysis in psychological research. Psychological Methods 1999,4(3):272–299.
Davison AC, Hinkley DV: Bootstrap Methods and their Application (Cambridge Series in Statistical and Probabilistic Mathematics). Cambridge University Press; 1997.
MacCallum RC, Widaman KF, Zhang S, Hong S: Sample size in factor analysis. Psychological Methods 1999, 4: 84–99.
Johnson MRD, Borde T: Representation of ethnic minorities in research – Necessity, opportunity and adverse effects. In Marginalized Reproduction: Ethnicity, Infertility and Reproductive Technologies. Edited by: Lorraine C, Nicky H, van Rooij F. London: Earthscan(Chapter 4); 2009:64–80.
Weich S, Nazroo J, Sproston K, McManus S, Blanchard M, Erens B, Karlsen S, King M, Lloyd K, Stansfeld S, Tyrer P: Common mental disorders and ethnicity in England: the EMPIRIC Study. Psychological Medicine 2004, 34: 1543–1551. 10.1017/S0033291704002715
Vaingankar J, Subramaniam M, Chong S, Abdin E, Orlando EM, Picco L, Lim Y, Phua M, Chua B, Tee J, Sherbourne C: The positive mental health instrument: development and validation of a culturally relevant scale in a multi-ethnic Asian population. Health and Quality of Life Outcomes 2011,9(1):1–18. 10.1186/1477-7525-9-1
Bennett P, Lip G, Silverman S, Blann A, Gill PS: Validation of the Edinburgh claudication questionnaire in 1st generation black African-Caribbean and South Asian UK migrants: a sub-study to the ethnic-echocardiographic heart of England screening (E-ECHOES) study. BMC Medical Research Methodology 2011,11(1):85. 10.1186/1471-2288-11-85
Currer CM: Health concepts and illness behaviour: The case of some Pathan mothers in Britain. Doctoral Thesis: University of Warwick; 1986.