Cross-cultural adaptation and validation of the treatment adherence questionnaire for Chinese patients with schizophrenia

Abstract

Background:Treatment adherence is crucial in managing schizophrenia, as nonadherence leads to relapse and increased societal burden. However, validated tools for assessing treatment adherence in Chinese patients with schizophrenia are lacking.
Objective:This study aimed to adapt the Treatment Adherence Questionnaire (TAQ) for the Chinese population and evaluate its psychometric properties.
Methods:A cross-sectional study was conducted with 252 Chinese patients diagnosed with schizophrenia. The TAQ was culturally adapted, and its structural validity was assessed through item analysis, structural equation modeling, and multigroup confirmatory factor analysis. Reliability, convergent validity, and content validity were also examined.
Results:We enrolled 252 patients (mean age 46.69 years; 46.8 % female; 19.8 % married). The Treatment Adherence Questionnaire demonstrated a three-factor structure. Content validity was excellent (0.960), and scale scores were positively correlated with the Medication Adherence Rating Scale, supporting construct validity. The questionnaire demonstrated high internal consistency, with Cronbach’s alpha of 0.931 and split-half reliability of 0.842. Group confirmatory factor analysis confirmed measurement invariance across gender, age, and disease course at the scalar level.
Conclusion:The Chinese version of the TAQ is a reliable and valid tool for assessing treatment adherence in Chinese patients with schizophrenia. Its use could improve clinical assessment and support better management outcomes for this population.

Ethical approval

This study was approved by the Ethics Committee of Harbin Medical University (Approval Number: HMUDQ20240507001). Written informed consent was obtained from all the participants.

Funding

This study was supported by the Natural Science Foundation of China (Grant No. 72074063), the Fundamental Research Funds for Provincial Universities (JFYQPY202303), and the Postgraduate Research & Practice Innovation Program of Harbin Medical University (YJSCX2023-300HYD). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

CRediT authorship contribution statement

Yubin Chen: Writing-review & editing, Writing-original draft, Visualization, Methodology, Formal analysis, Data curation, Conceptualization. Linghui Zhang: Writing-review & editing, Writing-original draft, Visualization, Methodology, Formal analysis, Data curation, Conceptualization. Yuqiu Zhou: Writing-review & editing, Writing-original draft, Supervision, Methodology, Data curation, Conceptualization. Hong Yu: Writing-review & editing, Data curation. Mohammad-Sajjad Lotfi: Conceptualization, Methodology, Writing-review & editing. Jiayuan Zhang: Writing-review & editing, Formal analysis, Data curation. Qi Li: Writing-review & editing, Writing-original draft, Data curation. All authors have read and approved the final version of this manuscript.

Declaration of Competing Interest

The authors declare no conflict of interest. Author Yuqiu Zhou is an editorial board member of Healthcare and Rehabilitation but has not been involved in the journal's review of or decisions related to this manuscript.

Acknowledgments

We express our profound gratitude to all the patients who participated in this study. We also extend our appreciation to the experts involved in the cross-cultural adaptation process for their valuable suggestions.

Data availability

The dataset utilized and/or analyzed in this study is available from the corresponding author upon reasonable request.

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