Validating a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for dementia caregivers

Objectives: The present study aimed to develop and validate a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for Hong Kong Chinese dementia caregivers.

Methods: The 12-item Zarit Burden Interview (ZBI) was translated into spoken Cantonese and back-translated by two bilingual research assistants and face validated by a panel of experts. Five hundred Chinese dementia caregivers showing signs of stress reported their burden using the translated ZBI and rated their depressive symptoms, overall health, and care recipients' physical functioning and behavioral problems. The factor structure of the translated scale was identified using principal component analysis and confirmatory factor analysis; internal consistency and item-total correlations were assessed; and concurrent validity was tested by correlating the ZBI with depressive symptoms, self-rated health, and care recipients' physical functioning and behavioral problems.

Results: The principal component analysis resulted in 11 items loading on a three-factor model comprised role strain, self-criticism, and negative emotion, which accounted for 59% of the variance. The confirmatory factor analysis supported the three-factor model (CZBI-Short) that explained 61% of the total variance. Cronbach's alpha (0.84) and item-total correlations (rho = 0.39–0.71) indicated CZBI-Short had good reliability. CZBI-Short showed correlations with depressive symptoms (r = 0.50), self-rated health (r = ?0.26) and care recipients' physical functioning (r = 0.18–0.26) and disruptive behaviors (r = 0.36).

Conclusions: The 12-item CZBI-Short is a concise, reliable, and valid instrument to assess burden in Chinese dementia caregivers in clinical and social care settings.     

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective

Background In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire – Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. Methods People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. Results A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40‐item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self‐determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P < 0.000, P < 0.01 and P < 0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α = 0.79). Conclusions Initial validity tests indicated that the Chinese Quality of Life Questionnaire – Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.     

Validation of the virtual-reality prospective memory test (Hong Kong Chinese version) for individuals with first-episode schizophrenia

This study was performed to examine the psychometric properties of a Virtual-Reality Prospective Memory Test (Hong Kong Chinese version; VRPMT-CV). The VRPMT was administered to 44 individuals with first-episode schizophrenia. The test was administered again 2 weeks later to establish test-retest reliability. The concurrent validity of the VRPMT was evaluated by examining the correlations between the VRPMT score and the score on the Chinese version of the Cambridge Prospective Memory Test (CAMPROMPT-CV). The performance of individuals with schizophrenia on the VRPMT was also compared with that of 42 healthy control subjects to examine the test’s sensitivity and specificity. The intraclass correlation for test–retest reliability of the total VRPMT–CV score was 0.78 (p?=?.005). A significant correlation was found between the total VRPMT-CV score and the total CAMPROMPT-CV score (r?=?0.90; p?相似文献   

Dementia quality of life instrument--construct and concurrent validity in patients with mild to moderate dementia

Background and purpose: To translate the Dementia quality of life instrument (DQoL) into German and assess its construct and concurrent validity in community‐dwelling people with mild to moderate dementia. Methods: Dementia quality of life instrument data of two pooled samples (n = 287) were analysed regarding ceiling and floor effects, internal consistency, factor reliability and correlations with corresponding scales on quality of life (Quality of Life in Alzheimer‘s Disease and SF‐12), cognition (Mini‐Mental State Examination, Alzheimer’s Disease Assessment Scale – cognitive), depression (Cornell Scale for Depression in Dementia) and activities of daily living (Interview of Deterioration in Daily Living Activities in Dementia). Results: We found no floor effects (<2%), minor ceiling effects (1–11%), moderate to good internal consistency (Cronbach’s α: 0.6–0.8) and factor reliability (0.6–0.8), moderate correlations with self‐rated scales of quality of life (Spearman coefficient: 0.3–0.6) and no or minor correlations with scores for cognition, depression or activities of daily living (r < 0.3). The original five‐factor model could not be confirmed. Conclusion: The DQoL can be used in dementia research for assessing positive and negative affect, feelings of belonging and self‐esteem. The findings suggest further research to improve the structure of the scales aesthetics, feelings of belonging and self‐esteem.     

The self-report Barthel Index: preliminary validation in people with Parkinson's disease

Background and purpose: To make a preliminary assessment of the reliability and validity of the self‐report Barthel Index (SRBI) in people with Parkinson’s (PWP) disease. Methods: Thirty‐nine PWP completed the SRBI, the self‐report Schwab & England (S & E) scale and the PDQ‐39. Standard statistical procedures were incorporated to assess the reliability and validity of the SRBI. Results: A Cronbach’s alpha coefficient of 0.69 was calculated, indicating adequate internal consistency. Reliability was further demonstrated through a Guttman split‐half reliability coefficient of 0.74. Validity was demonstrated through highly significant correlations between the SRBI and the S & E scale (r = 0.64, P < 0.00), the activities of daily living dimension of the PDQ‐39 (r = ?0.60, P < 0.00) and mobility dimension of the PDQ‐39 (r = ?0.49, P < 0.01). Conclusions: Results suggest that the SRBI has the potential to be a reliable and valid indicator of ADL in PWP and utilized in studies that make comparisons across conditions. Further validation is required in a larger sample and through assessment of additional psychometric properties.     

A dimensional approach to measuring anxiety for DSM‐5

In preparation for DSM‐5's planned inclusion of dimensional assessments of psychopathology as a complement to traditional categorical diagnoses, we developed brief self‐rated scales for anxiety disorders that are consistent in content and structure. In the present paper, we discuss the creation of the scales and examine their psychometric properties and clinical sensitivity. Phase One assessed psychometric properties of the initial versions of the scales in a large non‐clinical sample (n = 702). Phase Two assessed the psychometric properties of revised versions of the scales, including test–retest reliability, in a non‐clinical sample (n = 57). Phase Three examined the scales' psychometric properties and relationship with clinician ratings of disorder severity in a clinical sample (n = 48). The scales demonstrated internal consistency (α = 0.85–0.92), convergent validity (r_s = 0.39–0.69), and test–retest reliability in the non‐clinical samples (ICC = 0.51–0.81). In the clinical sample, the scales demonstrated significantly higher total scores than in the non‐clinical sample (Cohen's d = 0.72–1.50) and moderate to high correlations with clinician ratings of disorder severity (r = 0.43–0.82) Although further evaluation and refinement of the scales (particularly the specific phobia and agoraphobia scales) is needed, the results provide preliminary support for the use of these scales in DSM‐5 and thus take an important step toward the integration of standardized dimensional measurement into the diagnosis of anxiety disorders. Copyright © 2012 American Psychiatric Association. All rights reserved.     

Translation and validation of the arabic version of the revised 15‐item myasthenia gravis quality‐of‐life questionnaire

Introduction: We sought to translate, culturally adapt, and assess the Arabic version of the 15‐item myasthenia gravis quality‐of‐life revised scale (MGQOL15R). Methods: We assessed reliability with Cronbach α; reproducibility with intraclass correlation coefficient (ICC); validity with Spearman correlations for myasthenia gravis (MG)‐specific activities of daily living (MG‐ADL), MG composite (MGC) score, and MG manual muscle test (MG‐MMT) and with MGQOL15R in patients with different disease severity through the Kruskal–Wallis test; and sensitivity to change with Wilcoxon signed‐rank test. Results: In 65 enrolled patients, the mean MGQOL15R score was 10.84 ± 8.11 (α = 0.94, ICC = 0.95). The correlation coefficients between MGQOL15R and MGC, MG‐ADL, and MG‐MMT scores were 0.75, 0.75, and 0.74, respectively (P < 0.001). MGQOL15R scores were significantly higher (worse) in patients with more severe disease at baseline and significantly lower (better) in improved patients at follow‐up. Discussion: The Arabic version of MGQOL15R is valid, reliable, stable, and sensitive to changes. Muscle Nerve 57 : 581–585, 2018     

Development and validation of a fine-motor assessment tool for use with young children in a Chinese population

Objectives

Most of the fine-motor assessment tools used in Hong Kong have been designed in Western countries, so there is a need to develop a standardized assessment which is relevant to the culture and daily living tasks of the local (that is, Chinese) population. This study aimed to (1) develop a fine-motor assessment tool (the Hong Kong Preschool Fine-Motor Developmental Assessment [HK-PFMDA]) for use with young children in a Chinese population and (2) examine the HK-PFMDA's psychometric properties.

Method

The HK-PFMDA was developed by a group of occupational therapists specializing in the area of developmental disabilities in Hong Kong. A panel of 21 experts reviewed the content validity of the instrument. Rasch item analysis was used to examine the model fit of items against the rating scale model, and to explore the dimensionality of the test. Intra- and interrater reliability, convergent validity, and criterion-related validity were examined. The participants included 783 children without disabilities, 45 with autistic spectrum disorder, and 35 with developmental delay.

Results

The Rasch analysis suggested that the 87-item HK-PFMDA had a unidimensional structure, as the items explained most (91.6%) of the variance. The HK-PFMDA demonstrated excellent intra- (ICC = .99) and interrater reliability (ICC = .99), and internal consistency (α ranging from .83 to .92). In terms of validity, the HK-PFMDA had significant positive correlations with both age and the convergent measures of the Peabody Developmental Motor Scales (PDMS-2).

Conclusion

A set of normative data for local children aged from birth to 6 years was established. The HK-PFMDA has shown excellent psychometric properties and is suitable for clinical application by occupational therapists in the assessment of fine-motor skills development of young children in Chinese populations.     

RELIABILITY AND VALIDITY OF THE SPANISH VERSION OF THEGMS–AGECAT PACKAGE FOR THE ASSESSMENT OF DEMENTIA AND COGNITIVE DISTURBANCES

This report confirms the reliability and validity of the Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) package in a Spanish elderly population. No changes in the original English version are considered necessary. A representative sample (N=1080) of the elderly (65+ years) community in Zaragoza, Spain, stratified by age and sex was assessed. A two-phase screening was designed: phase I (lay interviewers): Spanish versions of GMS–AGECAT and Mini-Mental (MMSE); phase II (psychiatrists,N=324): the same instruments and History and Aetiology Schedule (HAS). Diagnosis: DSM-III-R criteria. Stringent test–retest reliability coefficients were calculated by comparing lay interviewers’ (phase I) vs psychiatrists’ (phase II) ratings. DSM-III-R psychiatric diagnoses in phase II were the gold standards for the validity study. Test–retest reliability coefficients of the cognitive sections of GMS were: case/no case distinction, mean kappa=0.71; dementia/no dementia distinction, mean kappa=0.80. GMS validity coefficients: detection of cases, sensitivity=98.4%; specificity=76.5%. Test–retest reliability coefficients of AGECAT: case/no case distinction, mean kappa=0.59; organic syndrome, dementia, mean kappa=0.68. Validity coefficients of AGECAT (psychiatrists’ outputs): case/no case distinction, sensitivity=90.6%; specificity=89.3%; dementia/no dementia distinction, sensitivity=86.4%; specificity=94.3%.     

Development of the Psychiatric Nurse Job Stressor Scale (PNJSS)

Aims: The aim of the present study was to develop a tool, the Psychiatric Nurse Job Stressor Scale (PNJSS), for measuring the stress of psychiatric nurses, and to evaluate the reliability and validity of the PNJSS. Methods: A total of 302 psychiatric nurses completed all the questions in an early version of the PNJSS, which was composed of 63 items and is based on past literature of psychiatric nurses' stress. Results: A total of 22 items from four factors, ‘Psychiatric Nursing Ability’, ‘Attitude of Patients’, ‘Attitude Toward Nursing’ and ‘Communication’, were extracted in exploratory factor analysis. With regard to scale reliability, the item–scale correlation coefficient was r = 0.265–0.570 (P < 0.01), the Cronbach alpha coefficient was 0.675–0.869, and the test–retest correlation coefficient was r = 0.439–0.771 (P < 0.01). With regard to scale validity, the convergent validity of the ‘job stressor’ scale was r = 0.172–0.420 (P < 0.01), and the predictive validity of the ‘job reaction’ scale was r = 0.201–0.453 (P < 0.01). The compatibility of the factor model to the data was 1.750 (χ²/d.f., 343.189/196, P < 0.01), the goodness of fit index was 0.910, the adjusted goodness of fit index was 0.883, the comparative fit index was 0.924, and the root mean square error of approximation was 0.050. Conclusions: The PNJSS has sufficient reliability and validity as a four‐factor structure containing 22 items, and is valid as a tool for evaluating psychiatric nurse job stressors.     

流产后抑郁障碍调查

目的：主要调查香港地区中国妇女流产后精神疾病的患病率。方法：对282名妇女在流产后6周用30项一般健康问卷（GHQ）、Edinburgh产后抑郁量表（EPDS）和Beck抑郁量表（BDI）进行评定,以DSM－Ⅲ-R定式检查（SCID）建立诊断,检验GHQ、EPDS与DSM－Ⅲ-R诊断间效标效度,以及和BDI间的平行效度。结果：29名妇女（10．3％）符合DSM-Ⅳ-R重症抑郁诊断,GHQ、EPDS具有良好的效标效度和平行效度。结论：中国香港妇女流产后精神障碍患病率降低,EPDS、GHQ适合用于综合性医院中流产后抑郁障碍的筛查。     

Validation of the Chinese version of the strengths and difficulties questionnaire in Hong Kong

Background  

The strengths and difficulties questionnaire (SDQ) is now one of the most commonly used instruments for screening child psychiatric morbidities. Psychometric studies in the West affirm its reliability and validity, but similar studies are scarce among non-Western populations. This is an important gap because cultural differences can influence how children’s behaviours are perceived and rated. This study explores the psychometric properties of the Chinese version of the SDQ among children in Hong Kong.     

Psychometric Properties of the Chinese Version of the Psycho-educational Profile-Revised (CPEP-R)

The purpose of this study was to examine the reliability and validity of the Chinese version of the Psycho-educational Profile-Revised (PEP-R). The Chinese PEP-R (CPEP-R) was administered to 63 preschool children with symptoms of autistic disorder recruited from special child-care centers in Hong Kong. Results showed that the scales of the CPEP-R were internally consistent, reliable across raters and temporally stable. Regarding the concurrent validity of the CPEP-R, the developmental score and developmental age assessed by the CPEP-R were significantly correlated with the Merrill–Palmer Scale of Mental Tests and the Hong Kong Based Adaptive Behavior Scale. The Behavioral Scale of the CPEP-R was also significantly related to the Childhood Autism Rating Scale. Besides replicating the findings in the Western context, the present study suggests that the psychometric properties of the PEP-R are stable across cultures and the related findings support the cross-cultural reliability of the tool.     

AGGRESSIVE BEHAVIOUR IN THE CHINESE ELDERLY—VALIDATION OF THE CHINESE VERSION OF THE RATING SCALE FOR AGGRESSIVE BEHAVIOUR IN THE ELDERLY (RAGE) IN HOSPITAL AND NURSING HOME SETTINGS

Objective. The objective is to examine the validity of the Chinese version of the Rating Scale for Aggressive Behaviour in the Elderly (RAGE) in Hong Kong. Design. A cross-sectional study comparing the pattern of aggressive behaviour among residents of different elderly institutions. Setting. A nursing home and a psychogeriatric inpatient unit. Patients. Psychogeriatric inpatients and nursing home residents. Thirty subjects participated in the validation study of the Chinese version of the RAGE (CRAGE). Eighty-eight subjects were assessed by the CRAGE for pattern of aggressive behaviour. Measures. The CRAGE and the Chinese version of the Mini-Mental State Examination (CMMSE). Results. The CRAGE showed satisfactory validity and reliability measures. Aggressive episodes were found in 57% of the subjects, mostly mild in nature. No significant difference was found in the CRAGE total scores in different institutions and across diagnoses. Hospital and schizophrenic patients had significantly higher ratings in overall aggressiveness. Demented subjects had higher CRAGE ratings with CMMSE scores from 11 to 15. Conclusions. CRAGE is a valid instrument for use in the Chinese elderly. Although there is no significant difference in total aggressive episodes among different elderly institutions, chronic psychiatric patients were more frequently regarded as aggressive.     

Distant visual acuity in chronic psychiatric patients. A pilot study

Background: There is a paucity of systematically collected data on visual impairment in patients with chronic psychiatric disorders. The aim of this pilot study was to estimate the magnitude of impairment of distant visual acuity (DVA) including refractive and non-refractive errors in institutionalized psychiatric patients awaiting resettlement in the community in Hong Kong. Method: DVA was tested using the Snellen method in a randomly selected cohort of 428 institutionalized psychiatric patients from the four long-stay rehabilitation units in Hong Kong. The pinhole method was employed to differentiate between refractive and non-refractive impairment of DVA. Results: Seventy-five percent of the sample had impaired DVA; 39 % of the subjects had refractive error (myopia). Only a small percentage of patients wore spectacles and had adequately corrected vision. Patients with impaired DVA were significantly older than those with normal DVA. Conclusion: While the frequency of myopia corresponds to that found in the general population in Hong Kong, the nature of non-refractive impairment needs further investigation including systematic eye examination, and examination of medication and life-style factors. Periodical eye examinations should be part of comprehensive health assessment for chronic psychiatric patients. Accepted: 27 May 2002     

Validation of the Chinese version of the Assessment of Preschool Children’s Participation for children with physical disabilities

Purpose: To examine the psychometric properties of the Chinese version of the Assessment of Preschool Children’s Participation (APCP-C). Method: The APCP, a measure of participation in play, skill development, active physical, and social activities of preschool children, was translated into Traditional Chinese. Data on 94 Taiwanese children with physical disabilities aged 2 to 6 years were analyzed. Results: Internal consistency (Cronbach’s α = 0.85 and 0.86) and test–retest reliability (ICCs = 0.79) were excellent for total scores, and varied from excellent to poor for activity type scores. Items were generally relevant to the Taiwanese culture. Correlations between scores for the APCP-C and the Chinese version of the Pediatric Evaluation of Disability Inventory Mobility and Social Functioning scales in general supported convergent validity (r = 0.33–0.68) but less support for discriminant validity. Conclusions: The results provide evidence of reliability, cross-cultural validity, and limited support for construct validity of the APCP-C in measuring participation of children with physical disabilities.     

A new measurement of activities of daily living for Thai elderly with dementia

BACKGROUND: Activities of daily living (ADL) vary across cultures, and measure of ADL needs to be specific to the population under study. We developed an ADL measure for Thai elderly with dementia and investigated the reliability and validity of this instrument. MATERIALS AND METHODS: Item construction was accomplished with a panel of neurologists and a rehabilitation medicine physician. One hundred eighty-one subjects were interviewed using the Thai ADL measure. Of this sample, one hundred fifty-nine had dementia according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. These data were analyzed for internal consistency; concurrent validity was determined by comparison with the Barthel Index, Functional Assessment Questionnaire (FAQ), Thai Mental State Exam (TMSE), and Clinical Dementia Rating (CDR) scale; and discriminant validity was determined by comparison with the Neuropsychiatric Inventory (NPI). Thirty subjects were tested to determine interrater and test-retest reliability. RESULTS: Thai ADL measure was composed of six basic ADL and seven instrumental ADL. It had high correlation with TMSE scores (r = -.69), CDR scores (r = .81), Barthel Index scores (r = -.80), and FAQ scores (r = .88), and moderate correlation with NPI scores (r = .46). The instrument had high test-retest reliability (intraclass correlation coefficient [ICC] = .92, .89) and high interrater reliability (ICC = .96, .93). CONCLUSION: The Thai ADL scale is easy to use and it has high reliability. It had high concurrent validity with previously published ADL scales. The methodology used to develop the Thai ADL scale can provide a model for creating culturally competent ADL scales.     

Development and initial reliability and validity of four self-report measures used in research on interactions between police officers and individuals with mental illnesses

There currently exists a dearth of reliable and valid instruments to examine key police officer variables of importance in the growing research on their interactions with individuals with mental illnesses. This study tested reliability and validity of four newly designed measures of the constructs of self-efficacy (Self-Efficacy Scale; SES), referral decisions and de-escalation skills (Behavioral Outcomes Scale; BOS), attitudes toward psychiatric treatment (Opinions about Psychiatric Treatment; OPT), and social distance (Adapted Social Distance Scale; ASDS) in a sample of law enforcement officers. Self-administered, anonymous surveys, which included the measures of interest, were completed by 177 officers—68 of whom were undergoing Crisis Intervention Team (CIT) training and 109 of whom were not—at the beginning and end of week-long trainings. Analyses examined the internal consistency reliability, test-retest reliability, and construct validity of the instruments. The four measures of interest were found to be reliable and valid. Specifically, internal consistency coefficients and test-retest reliability correlations were generally acceptable, all four demonstrated sensitivity to change, and validity correlations were significant and in the expected direction. Findings demonstrated the ability to measure key constructs related to attitudes and intended behaviors in law enforcement officers utilizing psychometrically sound instruments. Further testing and the development of additional reliable and valid instruments focused on attitudinal and behavioral domains among officers who have frequent interactions with individuals with mental illnesses would be of great value.     

Validation of the Chinese Handwriting Analysis System (CHAS) for primary school students in Hong Kong

There are more children diagnosed with specific learning difficulties in recent years as people are more aware of these conditions. Diagnostic tool has been validated to screen out this condition from the population (SpLD test for Hong Kong children). However, for specific assessment on handwriting problem, there seems a lack of standardized and objective evaluation tool to look into the problems. The objective of this study was to validate the Chinese Handwriting Analysis System (CHAS), which is designed to measure both the process and production of handwriting. The construct validity, convergent validity, internal consistency and test–retest reliability of CHAS was analyzed using the data from 734 grade 1–6 students from 6 primary schools in Hong Kong. Principal Component Analysis revealed that measurements of CHAS loaded into 4 components which accounted for 77.73% of the variance. The correlation between the handwriting accuracy obtained from HAS and eyeballing was r = .73. Cronbach's alpha of all measurement items was .65. Except SD of writing time per character, all the measurement items regarding handwriting speed, handwriting accuracy and pen pressure showed good to excellent test–retest reliability (r = .72–.96), while measurement on the numbers of characters which exceeded grid showed moderate reliability (r = .48). Although there are still ergonomic, biomechanical or unspecified aspects which may not be determined by the system, the CHAS can definitely assist therapists in identifying primary school students with handwriting problems and implement interventions accordingly.     

Reliability and validity of a Comprehensive Environmental Questionnaire for community-living elderly with healthcare needs

Background: Although environmental factors play an important role in the quality of life of the elderly, no currently available scale is adequate for the comprehensive assessment of the environments of community‐living elderly in Japan. The present study developed a Comprehensive Environmental Questionnaire to assess factors affecting quality of life and examined its reliability, criterion‐related validity, and construct validity among community‐living elderly with healthcare needs. Methods: Participants were 178 elderly adults without dementing disorders, aged 60 years and older, who were currently using day care services or home‐visit rehabilitative services. Participants were selected from five regions of Japan. We asked participants to complete the Comprehensive Environmental Questionnaire—provisional version twice (with a 1 month interval in between) and World Health Organization Quality of Life—brief form at baseline. Results: Based on exploratory factor analysis, we restructured the Comprehensive Environmental Questionnaire—provisional version to the final version, with 14 items and a three‐factor structure. Cronbach's alpha for internal consistency for all items was 0.82. Spearman's rank correlation coefficients for test–retest reliability were 0.4 or greater for 10 items, and were statistically significant (P < 0.001) for all items. The correlation coefficient of the total score of the Comprehensive Environmental Questionnaire and the environment domain score of the World Health Organization Quality of Life—brief form was 0.63 (P < 0.001). Confirmatory factor analysis indicated that the Comprehensive Environmental Questionnaire as a second‐order factor model was an adequate fit to the data. All standardized path coefficients in the model were statistically significant (P < 0.01). Conclusion: The present study established high levels of reliability, criterion‐related validity, and construct validity for the Comprehensive Environmental Questionnaire, with the exception of test–retest reliability for four items among community‐living elderly with healthcare needs.