Development of a psychosocial adaptation questionnaire for Chinese patients with visual impairments

To develop a psychosocial adaptation questionnaire for Chinese patients with visual impairments and to examine its reliability and validity.

Psychosocial adaptation with disease has been studied, however, there have been few reports on the impact of visual impairment on psychosocial adaptation. An instrument has not been developed to assess psychosocial adaptation with visual impairment specifically for patients in China.

Both qualitative and quantitative research methods were used. A questionnaire was developed based on the concept of psychosocial adaptation with visual impairment. Items for the questionnaire were developed by reviewing the literature and carrying out a semi-structured interview with 12 visually impaired patients. Five ophthalmologists and ten patients evaluated the content validity and face validity of the questionnaire, respectively. The method of convenient sampling was used to select 213 visually impaired patients in the Ophthalmology Department of the First Affiliated Hospital of China Medical University to participate in the study. Discriminative index and item-total correlation analyses were used to delete items that were lower than a set criterion. Regarding construct validity, factor analysis was performed. The Self-rating Anxiety Scale (SAS), General Self-Efficacy Scale (GSES) and Self Acceptance Questionnaire (SAQ) were used to evaluate criterion validity. Cronbach's alpha coefficient was used as an index of internal consistency. To evaluate test-retest reliability, 50 patients were re-evaluated after 24 hours.

A total of 204 questionnaire items were created. 22 items were deleted by discriminative index and item-total correlation before factor analysis; 38 items were entered into the model for factor analysis. Seven factors were extracted by using principal factor analysis and varimax rotation, with a cumulative contribution of 59·18%. The correlation coefficients between the psychosocial adaptation questionnaire for visual impairment and the SAS, GSES and SAQ were -0·771, 0·754 and 0·722, respectively (p < 0·01). The Cronbach's alpha coefficient for the psychosocial adaptation questionnaire was 0·948. The alpha coefficients of seven sub-questionnaires ranged from 0·56-0·89. The correlation coefficients for the total questionnaire and seven sub-questionnaires ranged from 0·97-0·99 (p < 0·01).

The results of this study confirmed the reliability and validity of the 38-item psychosocial adaptation questionnaire for the visually impaired in China. It therefore can be used as a measurement tool for widespread, cost-effective clinical assessment and further research.

The new tool may help nurses and other clinical personnel to evaluate the psychosocial adaptation of visually impaired patients and provide a suitable basis for assisting with adaptation to visual impairment and enhancing quality of life.