title: Psychometric properties of the Japanese version of the Recovery Attitudes Questionnaire (RAQ) among mental health providers: a questionnaire survey.
abstract: BACKGROUND
  "Recovery" is a central concept in mental health, particularly for mental health services and policy-makers. The present study examined the factorial and concurrent validity, internal consistency reliability, and test-retest reliability of the Japanese version of the 7-item Recovery Attitudes Questionnaire (RAQ) among mental health service providers in community and inpatient settings in Japan.
  
  
  METHODS
  We conducted a cross-sectional questionnaire with a number of eligible professional groups, including psychiatrists, registered/assistant nurses, public health nurses, clinical psychologists, pharmacists, occupational therapists, and social workers. Participants were drawn from two psychiatric hospitals and 56 psychiatric clinics or community service agencies. In total, 331 participants completed the questionnaire. After excluding those with missing RAQ values, 307 participants were included in the analysis; the participants' mean age was 40.2 years and 29.6 % were men. The questionnaire comprised the Japanese version of the 7-item RAQ developed by the present authors, the revised scale of the positive attitudes of staff toward persons with mental disorder (the positive attitudes scale), and the Japanese-language version of the Social Distance Scale (SDSJ). Confirmatory factor analyses were used to examine factorial validity of a two-factor structure reported in a previous study (Borkin et al., 2000) as well as a single-factor structure. Concurrent validity was determined by calculating correlations between RAQ and the other two scales. Internal consistency reliability was assessed with Cronbach's alpha coefficients and inter-item correlations. Test-retest reliability was assessed by the intraclass correlation coefficient (ICC), with a weighted kappa in a subsample of participants (n = 13).
  
  
  RESULTS
  The two-factor structure showed acceptable factorial validity. RAQ scores were significantly and positively correlated with the positive attitudes scale, and there was a significant inverse correlation with the SDSJ (p < 0.01). The RAQ had an overall Cronbach's alpha coefficient of 0.64. Four inter-item correlations were not significant. The ICC and weighted kappa values indicated unsatisfactory test-retest reliability.
  
  
  CONCLUSIONS
  The Japanese RAQ showed acceptable factorial validity, reasonable concurrent validity, and unsatisfactory reliability in community and inpatient mental health settings in Japan. Further large-scale research is required to ensure robust verification.
authors.affiliation: School of Nursing, Jichi Medical University, 3311-159, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan. crie-tky@umin.ac.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Chiba
authors.affiliation: Faculty of Community Health Nursing/ Public Health Nursing, St Luke's, International University, 10-1, Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan. makiumeda46@gmail.com.
authors.forename: Maki
authors.initials: M
authors.lastname: Umeda
authors.affiliation: Tokyo Musashino Hospital, 4-11-11, Komone, Itabashi-ku, Tokyo, 173-0037, Japan. whimsical-angels@umin.ac.jp.
authors.forename: Kyohei
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yyuki-tky@umin.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Department of Psychiatric Rehabilitation, Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8553, Japan. sosei.yama@ncnp.go.jp.
authors.forename: Sosei
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. norito@m.u-tokyo.ac.jp.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health / Q000592:standards; D008605:Mental Health Services; D011594:Psychometrics / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014177:Translations