Reliability and validity of the Japanese version of the Recovery Assessment Scale (RAS) for people with chronic mental illness: scale development
Abstract
Background Recovery is defined as a complex process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. To promote this process, the necessity of recovery assessment using psychometric measures has been emphasized; however, no measure to assess the individual recovery process is available in Japan.Objective To develop a Japanese version of the Recovery Assessment Scale (RAS) and to examine its reliability and validity.Design The study was a cross-sectional questionnaire survey.Settings Participants came from 1 daycare, 1 outpatient clinic of a psychiatric hospital, 5 sheltered workshops used for social rehabilitation, 3 peer support groups, and 6 inpatient wards of 2 psychiatric hospitals.Participants The survey included 237 participants who had chronic mental illness and were aged 20 or older. For analysis, we used data from 209 participants who had no missing values on the RAS, with 58.9% male and a mean age of 48.3 years.Methods The questionnaire consisted of the Japanese version of the 24-item RAS, developed by the authors with focus group cognitive interviews and the translation-back-translation procedure. Also included were the Herth Hope Index, Empowerment scale, Resilience scale, SF-8, and BASIS-32. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and weighted kappa in a randomly selected subsample (n=24). Exploratory and confirmatory factor analyses and correlations with other scales were used to examine the factor-based validity, concurrent and construct validity of the RAS.Results Cronbach's alpha coefficient was 0.89 for the overall RAS. ICC and weighted kappa generally indicated good test-retest reliability. Factor analysis of the RAS items yielded five factors: (a) goal/success orientation and hope, (b) reliance on others, (c) personal confidence, (d) no domination by symptoms, and (e) willingness to ask for help. The item "Coping with mental illness is no longer the main focus of my life" showed an inverse factor loading. The overall RAS score significantly and positively correlated with the Herth Hope Index, Empowerment scale, Resilience scale, and SF-8 mental component summary; there was a significant negative correlation with BASIS-32 psychiatric symptoms and functional impairment (p<0.01).Conclusion This study confirmed the reliability and validity of the Japanese version of the 24-item RAS among people with chronic mental illness currently living in communities and inpatient ward settings in Japan.
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There has been criticism about personal recovery being defined in individualistic terms that neglect collectivist values more present in some cultural groups.
“There has, however, been criticism about personal recovery being defined in individualistic terms (16) that neglect collectivist values that are more present in some cultural groups (17–20).”
From Recovery from Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives (2021) · cites this paper as [20]
The integral role in personal recovery of family and community has been especially mentioned in literature referring to cultures that focus more on group goals than on self-responsibility.
“The integral role in personal recovery of family and community has been especially mentioned in literature referring to cultures that focus more on group goals than on self-responsibility (20, 89).”
From Recovery from Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives (2021) · cites this paper as [20]
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- Authors
- Chiba, R., Miyamoto, Y., & Kawakami, N.
- Affiliations
- The University of Tokyo (JP)
- Corresponding author
- Chiba, Rie
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 47
- Issue
- 3
- Pages
- 314-322
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2043921732
- Cited by
- 97
- References
- 55
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 8 · 2019: 4 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 4
- FWCI
- 6.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yuumi Memorial Foundation for Home Health Care
- Ministry of Education, Culture, Sports, Science and Technology (19791744)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- Recovery Assessment Scale, mental health recovery, chronic mental illness, Japanese translation, scale development, psychometric validation, hope, empowerment, resilience, social functioning, functional disability, psychiatric symptoms, cross-cultural adaptation, cognitive interviewing, test-retest reliability, factor structure, Herth Hope Index, empowerment scale, Resilience Scale
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Attitude to Health, Mental Disorders, Chronic Disease, Cross-Sectional Studies, Factor Analysis, Statistical, Female, Humans, Japan, Male, Middle Aged, Morale, Nursing Assessment, Power, Psychological, Psychometrics, Surveys and Questionnaires, Self-Assessment, Social Support, Nursing Evaluation Research, Chi-Square Distribution, Self Efficacy, Resilience, Psychological
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