Assessments of the Factor Structure and Psychometric Properties of the Persian Version of the 30-Item Drug Attitude Inventory in Patients with Schizophrenia

Document Type : Original Article

Authors

1 Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

2 Department of Nursing, Zeynab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

3 Neuroscience Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran

10.34172/ahj.1635

Abstract

Background: Schizophrenia is a debilitating psychiatric disorder in which non-adherence to medication leads to symptom relapse, rehospitalization, reduced quality of life, and increased treatment costs; therefore, an appropriate tool is needed to assess the attitudes of patients with schizophrenia towards medication.
Methods: Three hundred patients with schizophrenia enrolled at the specialized neuropsychiatric clinic at Shafa Hospital in Rasht 2023 participated in this cross-sectional study. The patients filled out the Drug Attitude Inventory-30 (DAI-30) and a demographic questionnaire. Qualitative and quantitative methods were used to evaluate content validity. Face validity was assessed using qualitative content validity, and the content validity ratio (CVR) and content validity index (CVI) were computed for quantitative content validity. Kolmogorov-Smirnov test was used to assess the normal distribution of the questionnaire scores. Reliability was assessed using test-retest procedures and Cronbach’s alpha. Data were analyzed using SPSS version 26, and confirmatory factor analysis (CFA) and model fit were performed using Smart PLS version 8.8. A P value < 0.05 was considered statistically significant.
Findings: In this study, 211 participants (70.33%) were male and the mean ± standard deviation (SD) of age was 40.32 ± 10.87 years. All items of the Persian version of DAI-30 showed a CVR greater than 0.62 and CVI greater than 0.80, confirming their content validity. Construct validity showed sufficient internal correlations for conducting exploratory factor analysis (EFA). Cronbach’s alpha for reliability was 0.983. The test-retest correlation coefficient was high (r = 0.936, P < 0.001).
Conclusion: The findings of this study recommend that the Persian version of the DAI-30 is a relevant and reliable measure for evaluating drug attitudes in patients with schizophrenia

Keywords

References

  1. Sayed Mousavi Paske S, Fathi Ashtiani A, Ashrafi E. Psychometric properties of schizophrenia caregivers questionnaire. J Res Behav Sci. 2020;18(2):192-201. doi: 10.52547/rbs.18.2.192. [Persian].
  2. Mohammadi Z, Khalaatbari J, Ghahari S, Zarenezhad M, Mahmoodi N, Kalani N. The effectiveness of cognitive behavioral therapy on quality of life in schizophrenic patients. Med J Mashhad Univ Med Sci. 2018;61(5):3868-76. doi: 10.22038/mjms.2021.20170. [Persian].
  3. McCutcheon RA, Marques TR, Howes OD. Schizophrenia— an overview. JAMA Psychiatry. 2020;77(2):201-10. doi: 10.1001/jamapsychiatry.2019.3360.
  4. Correll CU, Schooler NR. Negative symptoms in schizophrenia: a review and clinical guide for recognition, assessment, and treatment. Neuropsychiatr Dis Treat. 2020;16:519-34. doi: 10.2147/ndt.S225643.
  5. Sun Y, Tong J, Feng Y, Fang H, Jiang T, Zhao L, et al. Attitude and influencing factors of patients with schizophrenia toward long-acting injections: a community-based cross-sectional investigation in China. Front Public Health. 2022;10:951544. doi: 10.3389/fpubh.2022.951544.
  6. Kane JM, McEvoy JP, Correll CU, Llorca PM. Controversies surrounding the use of long-acting injectable antipsychotic medications for the treatment of patients with schizophrenia. CNS Drugs. 2021;35(11):1189-205. doi: 10.1007/s40263- 021-00861-6.
  7. Nagai N, Tani H, Yoshida K, Gerretsen P, Suzuki T, Ikai-Tani S, et al. Drug attitude, insight, and patient’s knowledge about prescribed antipsychotics in schizophrenia: a cross-sectional survey. Neuropsychiatr Dis Treat. 2020;16:781-7. doi: 10.2147/ndt.S240377.
  8. Ghosh P, Balasundaram S, Sankaran A, Chandrasekaran V, Sarkar S, Choudhury S. Factors associated with medication non-adherence among patients with severe mental disorder - a cross sectional study in a tertiary care centre. Explor Res Clin Soc Pharm. 2022;7:100178. doi: 10.1016/j. rcsop.2022.100178.
  9. Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Syst Rev. 2020;9(1):17. doi: 10.1186/s13643-020-1274-3.
  10. Sowunmi OA. Psychometric properties of drug attitude inventory among patients with schizophrenia. S Afr J Psychiatr. 2022;28:1760. doi: 10.4102/sajpsychiatry.v28i0.1760.
  11. Loots E, Goossens E, Vanwesemael T, Morrens M, Van Rompaey B, Dilles T. Interventions to improve medication adherence in patients with schizophrenia or bipolar disorders: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(19):10213. doi: 10.3390/ijerph181910213.
  12. Novick D, Montgomery W, Treuer T, Aguado J, Kraemer S, Haro JM. Relationship of insight with medication adherence and the impact on outcomes in patients with schizophrenia and bipolar disorder: results from a 1-year European outpatient observational study. BMC Psychiatry. 2015;15:189. doi: 10.1186/s12888-015-0560-4.
  13. Kim J, Ozzoude M, Nakajima S, Shah P, Caravaggio F, Iwata Y, et al. Insight and medication adherence in schizophrenia: an analysis of the CATIE trial. Neuropharmacology. 2020;168:107634. doi: 10.1016/j.neuropharm.2019.05.011.
  14. Tessier A, Boyer L, Husky M, Baylé F, Llorca PM, Misdrahi D. Medication adherence in schizophrenia: the role of insight,therapeutic alliance and perceived trauma associated with psychiatric care. psychiatry Res. 2017;257:315-21. doi: 10.1016/j.psychres.2017.07.063.
  15. Bahreini M, Rafiee Z, Pouladi S, Mirzaei K, Mohammadi Baghmollaei M. Psychometric properties of the medication non-adherence questionnaire in patients with psychiatric disorders. Jundishapur J Chronic Dis Care. 2015;4(3):e27062. doi: 10.5812/jjcdc.27062v2.
  16. Ishii J, Kodaka F, Miyata H, Yamadera W, Seto H, Higuchi H, et al. Association between functional recovery and medication adherence in schizophrenia. Neuropsychopharmacol Rep. 2022;42(4):510-5. doi: 10.1002/npr2.12294.
  17. Nielsen RE, Lindström E, Nielsen J, Levander S. DAI-10 is as good as DAI-30 in schizophrenia. Eur Neuropsychopharmacol. 2012;22(10):747-50. doi: 10.1016/j.euroneuro.2012.02.008.
  18. Dai N, Huang B, Gao T, Zheng Y, Shi C, Pu C, et al. Initial attitudes toward a drug predict medication adherence in first-episode patients with schizophrenia: a 1-year prospective study in China. BMC Psychiatry. 2023;23(1):907. doi: 10.1186/s12888-023-05419-y.
  19. Abdulkareem MM, Mohammad Amin NM. Adherence to medication for schizophrenia in a psychiatric outpatient clinic in Sulaimani. Arab J Psychiatry. 2021;32(2):141-53. doi: 10.12816/0059215.
  20. Shariati B, Shabani A, Ariana-Kia E, Ahmadzad-Asl M, Alavi K, Mousavi Behbahani Z, et al. Drug attitude inventory in patients with bipolar disorder: psychometric properties. Iran J Psychiatry Behav Sci. 2018;12(3):e9831. doi: 10.5812/ ijpbs.9831.
  21. Kyriazos TA. Applied psychometrics: sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology. 2018;9(8):2207-30. doi: 10.4236/ psych.2018.98126.
  22. Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med. 1983;13(1):177-83. doi: 10.1017/s0033291700050182.
  23. Awad AG, Voruganti LN, Heslegrave RJ, Hogan TP. Assessment of the patient’s subjective experience in acute neuroleptic treatment: implications for compliance and outcome. Int Clin Psychopharmacol. 1996;11 Suppl 2:55-9. doi: 10.1097/00004850-199605002-00009.
  24. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee- Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8(2):94-104. doi: 10.1111/j.1524-4733.2005.04054.x.
  25. Roopun KR, Tomita A, Paruk S. Attitude and preferences towards oral and long-acting injectable antipsychotics in patients with psychosis in KwaZulu-Natal, South Africa. S Afr J Psychiatr. 2020;26:1509. doi: 10.4102/sajpsychiatry. v26i0.1509.
Addiction & Health
Volume 17
Pages 1-8

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