The Reliability and Validity of the Korean Version of Patient Rejection Scale (K-PRS)

Ju-Hee Han; Jong-Hyun Jeong; Seung-Chul Hong; Jin-Hee Han; Soo Hyun Joo; Tae Won Kim; Ho-Jun Seo

doi:10.4306/jknpa.2013.52.3.122

Journal List > J Korean Neuropsychiatr Assoc > v.52(3) > 1017622

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Han, Jeong, Hong, Han, Joo, Kim, and Seo: The Reliability and Validity of the Korean Version of Patient Rejection Scale (K-PRS)

Original Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2013; 52(3): 122-129.

Published online: 31 May 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.3.122

The Reliability and Validity of the Korean Version of Patient Rejection Scale (K-PRS)

Ju-Hee Han, MD, Jong-Hyun Jeong, MD, Seung-Chul Hong, MD, Jin-Hee Han, MD, Soo Hyun Joo, MD, Tae Won Kim, MD, Ho-Jun Seo, MD, PhD

Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address for correspondence: Ho-Jun Seo, MD, PhD. Department of Neuropsychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 442-723, Korea. Tel +82-31-249-8038, Fax +82-31-248-6758, healm@catholic.ac.kr

Received 4 April 2013 Revised 22 April 2013 Accepted 23 April 2013

Abstract

Objectives

The Patient rejection scale (PRS) has been reported as a valid tool for the assessment of rejecting feelings of family respondents toward schizophrenics who return to live with their families. The aim of this study was to assess the reliability and validity of the Korean-version of PRS (K-PRS).

Methods

A sample of 272 primary caregivers of schizophrenics completed the K-PRS and the data were analyzed for internal consistency and factor structure. Additionally 117 caregivers refilled K-PRS after two weeks for test-retest reliability. To test for validity, Family Questionnaire (FQ), Drug Attitude Inventory-10 (DAI-10) and the Scale to Assess Unawareness of Mental Disorder (SUMD) were administered.

Results

Internal consistency of K-PRS was good (Cronbach' alpha=0.787) and principal component factor analysis revealed the three-factor structure. The K-PRS also showed reasonable test-retest reliability (r=0.795). Convergent validity was examined through correlations between the K-PRS and the FQ-criticism subscale (r=0.78). Divergent validity was examined through correlations between the K-PRS and KDAI-10 (r=-0.02, p=0.001), and between the K-PRS and SUMD-K (r=-0.02, p=0.796).

Conclusion

The Korean version of PRS proved to be a reliable and valid instrument measuring rejecting feelings in relatives of Korean patients with schizophrenia.

Keywords: Patient rejection scale, Rejecting feelings, Reliability, Validity

Figures and Tables

Table 1

Sociodemographic and clinical characteristics of the subjects (n=272)

Table 2

Pearson's correlations between Korean version of Patient Rejection Scale and other questionnaires

^*: p<0.01. K-PRS : Korean version of Patient Rejection Scale, FQ-CC : Family Questionnaire-Criticism, FQ-EOI : Family Questionnaire-Emotional over-involvement, SUMD-K : Korean version of the Scale to Assess Unawareness of Mental Disorder, KDAI-10 : Korean version of Drug Attitude Inventory-10

Table 3

Factor loadings for each item of Korean version of Patient Rejection Scale

Notes

The authors have no financial conflicts of interest.

References

1. Kim CK, Cho JS, Seo JM, Kim YK, Kim HC, Kim HS, et al. A preliminary study for the development of the family burden scale of the schizophrenics. J Korean Neuropsychiatr Assoc. 1999. 38:539–553.

2. Andrews G, Hall W, Goldstein G, Lapsley H, Bartels R, Silove D. The economic costs of schizophrenia. Implications for public policy. Arch Gen Psychiatry. 1985. 42:537–543.

3. Gibbons JS, Horn SH, Powell JM, Gibbons JL. Schizophrenic patients and their families. A survey in a psychiatric service based on a DGH unit. Br J Psychiatry. 1984. 144:70–77.

4. Hatfield AB. Help-seeking behavior in families of schizophrenics. Am J Community Psychol. 1979. 7:563–569.

5. Kim JH, Lee JI, Lee CH, Kwon HY, Yim SJ, Kim ST. Links between subjective insight of patients with schizophrenia and burden of care in relatives of patients with schizophrenia. Korean J Schizophr Res. 2005. 8:10–16.

6. Brown GW, Birley JL, Wing JK. Influence of family life on the course of schizophrenic disorders: a replication. Br J Psychiatry. 1972. 121:241–258.

7. Vaughn CE, Leff JP. The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. Br J Psychiatry. 1976. 129:125–137.

8. Hooley JM. Expressed emotion and relapse of psychopathology. Annu Rev Clin Psychol. 2007. 3:329–352.

9. Wiedemann G, Rayki O, Feinstein E, Hahlweg K. The Family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Res. 2002. 109:265–279.

10. Van Humbeeck G, Van Audenhove Ch, De Hert M, Pieters G, Storms G. Expressed emotion: a review of assessment instruments. Clin Psychol Rev. 2002. 22:323–343.

11. Bae HS. Study on development of korean version scale of psychiatry patient perceived family expressed emotion. 2000. Daegu: Keimyung University;[Master's degree].

12. Cole JD, Kazarian SS. The Level of Expressed Emotion Scale: a new measure of expressed emotion. J Clin Psychol. 1988. 44:392–397.

13. Kreisman DE, Simmens SJ, Joy VD. Rejecting the patient: preliminary validation of a self-report scale. Schizophr Bull. 1979. 5:220–222.

14. Watzl H, Rist F, Cohen R. The patient rejection scale: cross-cultural consistency. Schizophr Bull. 1986. 12:236–238.

15. Gerlsma C. De "Level of Expressed Emotion" schaal. Psychodiagnostisch gereedschap. [The Level of Expressed Emotion Scale: A psychodiagnostic instrument]. De Psychology. 1998. 33:503–508.

16. Wamboldt FS, O'Connor SL, Wamboldt MZ, Gavin LA, Klinnert MD. The five minute speech sample in children with asthma: deconstructing the construct of expressed emotion. J Child Psychol Psychiatry. 2000. 41:887–898.

17. Kim JH, Kim D, Kang YM, Park SH, Lee CH, Chang DW. The reliability and validity of the Korean version of family questionnaire: a questionnaire measuring expressed emotion. J Korean Neuropsychiatr Assoc. 2007. 46:144–150.

18. Hogan TP, Awad AG. Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychol Med. 1992. 22:347–352.

19. Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med. 1983. 13:177–183.

20. Yoon BH, Sea YH, Bae SO, Lee ES, Lee HY. Subjective Response to Atypical and Typical Antipsychotics in Schizophrenic Inpatients. J Korean Soc Biol Ther Psychiatry. 2002. 8:298–304.

21. Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM. Assessment of insight in psychosis. Am J Psychiatry. 1993. 150:873–879.

22. Song JY, Kim KT, Lee SK, Kim YH, Noh JH, Kim JW, et al. Reliability and Validity of the Korean Version of the Scale to Assessment Unawareness of Mental Disorder (SUMD-K). J Korean Neuropsychiatr Assoc. 2006. 45:307–315.

23. Kazarian SS. The measurement of expressed emotion: a review. Can J Psychiatry. 1992. 37:51–56.

24. Leff JP, Vaughn C. Expressed emotion in families: It's significance for mental illness. 1985. New York: Guilford press.

25. Barrowclough C, Hooley JM. Attributions and expressed emotion: a review. Clin Psychol Rev. 2003. 23:849–880.

26. Schulze Mönking H, Buchkremer G. Emotional family atmosphere and relapse: investigations on the role of relapse definition, duration of illness and resignation of relatives. Eur Psychiatry. 1995. 10:85–91.

27. Bebbington P, Kuipers L. The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med. 1994. 24:707–718.

28. Parker G, Hadzi-Pavlovic D. Expressed emotion as a predictor of schizophrenic relapse: an analysis of aggregated data. Psychol Med. 1990. 20:961–965.

29. Butzlaff RL, Hooley JM. Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry. 1998. 55:547–552.

30. Kavanagh DJ. Recent developments in expressed emotion and schizophrenia. Br J Psychiatry. 1992. 160:601–620.

31. Tarrier N, Barrowclough C. Psychophysiological assessment of expressed emotion in schizophrenia. A case example. Br J Psychiatry. 1984. 145:197–200.

32. Tarrier N, Barrowclough C, Porceddu K, Watts S. The assessment of psychophysiological reactivity to the expressed emotion of relatives of schizophrenic patients. Br J Psychiatry. 1988. 152:618–624.

33. Sellwood W, Tarrier N, Quinn J, Barrowclough C. The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion. Psychol Med. 2003. 33:91–96.

34. Hahlweg K, Goldstein MJ, Nuechterlein KH, Magaña AB, Mintz J, Doane JA, et al. Expressed emotion and patient-relative interaction in families of recent onset schizophrenics. J Consult Clin Psychol. 1989. 57:11–18.

35. Kim WS. Psychological Testing. 1994. Seoul: Yulgokbook publisher.

36. Cheon BR. Research Methodology. 1994. Daegu: Department of Preventive Medicine, Kyungpook National University School of Medicine.

37. Bailer J, Rist F, Bräuer W, Rey ER. Patient Rejection Scale: correlations with symptoms, social disability and number of rehospitalizations. Eur Arch Psychiatry Clin Neurosci. 1994. 244:45–48.

38. Heresco-Levy U, Brom D, Greenberg D. The Patient Rejection Scale in an Israeli sample: correlations with relapse and physician's assessment. Schizophr Res. 1992. 8:81–87.

39. Gerlsma C, van der Lubbe PM, van Nieuwenhuizen C. Factor analysis of the level of expressed emotion scale, a questionnaire intended to measure 'perceived expressed emotion'. Br J Psychiatry. 1992. 160:385–389.

40. Gavazzi SM, McKenry PC, Jacobson JA, Julian TW, Lohman B. Modeling the effects of expressed emotion, psychiatric symptomology, and marital quality levels on male and female verbal aggression. J Marriage Fam. 2000. 62:669–682.

41. Heinrichs DW, Hanlon TE, Carpenter WT Jr. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull. 1984. 10:388–398.

42. Tienari P, Wynne LC, Sorri A, Lahti I, Läksy K, Moring J, et al. Genotype-environment interaction in schizophrenia-spectrum disorder. Long-term follow-up study of Finnish adoptees. Br J Psychiatry. 2004. 184:216–222.

43. Falloon IR, Boyd JL, McGill CW, Williamson M, Razani J, Moss HB, et al. Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two-year longitudinal study. Arch Gen Psychiatry. 1985. 42:887–896.

44. Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Ulrich RF, et al. Environmental-Personal Indicators in the Course of Schizophrenia (EPICS) Research Group. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Arch Gen Psychiatry. 1991. 48:340–347.

TOOLS

Similar articles