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chronic illness, concept of health, scale development



  1. Hwu, Yueh-Juen
  2. Coates, Vivien E.
  3. Boore, Jennifer R. P.
  4. Bunting, Brendan P.


Background: As the concept of health in Chinese people with chronic illness had not been previously explored, a scale to measure this concept in this client group was developed.


Objective: To develop and test the psychometric integrity of the Concept of Health Scale (CHS) for use with Chinese people.


Methods: Previous nursing experience and a literature review were used to inform the initial development of the CHS. It was revised following scrutiny by a panel of experts. Two studies tested the psychometric integrity of the scale. In Study One the data gathered from 80 Chinese people with a chronic illness were subjected to item analysis and exploratory factor analysis. In Study Two, with a convenience sample of 372 chronically ill Chinese people, confirmatory factor analysis was conducted.


Results: Instrument analysis in Study One resulted in a 34-item scale with a Cronbach alpha of 0.94. The results of an exploratory factor analysis showed that physical, psychosocial, and spiritual factors were represented by the CHS. The hypothesized model of the CHS was tested in Study Two using confirmatory factor analyses. The results of this study indicated that the concept of health was comprised of six first-order and three second-order factors.


Conclusion: The results of this study demonstrated that Chinese people with chronic illness held a broad frame of reference in gauging the concept of health. The development of the CHS brings us one step closer to understanding how Chinese people with chronic illness regard the concept of health.