title: Holistic Health Status Questionnaire: developing a measure from a Hong Kong Chinese population.
abstract: BACKGROUND
  The increased prevalence of chronic diseases is a global health issue. Once chronic disease is diagnosed, individuals face lifelong healthcare treatments, and the disabilities and disturbances resulting from their illness will affect the whole person. A valid tool that can measure clients' holistic care needs is important to enable us to identify issues of concern and address them early to prevent further complications. This study aimed to develop and evaluate the psychometric properties of a scale measuring holistic health among chronically ill individuals.
  
  
  METHODS
  The research was an instrument development and validation study using three samples of Hong Kong Chinese people. The first sample (n = 15) consisted of stroke survivors who had experienced disruption of their total being, and was used as a basis for the generation of scale items. In the second and third samples (n = 319, n = 303), respondents with various chronic illnesses were assessed in order to estimate the psychometric properties of the scale. A total of 52 items were initially generated, and 7 items with a factor loading less than 0.3 were removed in the process, as substantiated by the literature and expert panel reviews.
  
  
  RESULTS
  Exploratory factor analysis identified a 45-item, 8-factor Holistic Health Status Questionnaire (HHSQ) that could account for 56.38 % of the variance. The HHSQ demonstrated content validity, acceptable internal consistency (0.59-0.92) and satisfactory convergent validity from moderate to high correlation with similar constructs (r ≥ 0.46, p < 0.01).
  
  
  CONCLUSIONS
  The HHSQ tapped into the relational experiences and connectedness among the bio-psycho-social-spiritual dimensions of a Chinese person with chronic disease, with acceptable psychometric properties.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. cw.chan@polyu.edu.hk.
authors.forename: Choi Wan
authors.initials: CW
authors.lastname: Chan
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. frances.wong@polyu.edu.hk.
authors.forename: Frances Kam Yuet
authors.initials: FK
authors.lastname: Wong
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. sue.yeung@connect.polyu.hk.
authors.forename: Siu Ming
authors.initials: SM
authors.lastname: Yeung
authors.affiliation: Nethersole Institute of Continuing Holistic Health Education, Room J-7-28, 11 Chuen On Road, Tai Po, NT, Hong Kong. foksum@nethersole.org.hk.
authors.forename: Fok
authors.initials: F
authors.lastname: Sum
mesh_terms: D000328:Adult; D000368:Aged; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006694:Holistic Health; D006723:Hong Kong; D006801:Humans; D008297:Male; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires