Development and validation of the Help-Seeking Motivation Scale for patients with schizophrenia (HSMS）

Objective Schizophrenia is one of the mental disorders with the longest delay in treatment. Motivation for help-seeking is an important factor in getting professional treatment. There is no instrument to measure help-seeking motivation in schizophrenia. We aim to develop a scale to provide a valid measurement tool for assessing help-seeking motivation in this population. Methods A literature review and semi-structured interviews were used to construct the dimensions and item pool. Then, the scale was adjusted according to the results of Delphi study, cognitive interviews and pilot survey. Next, we screened the items and determined the potential structure via item analysis and exploratory factor analysis. Lastly, we tested the reliability and validity. Results Exploratory factor analysis and confirmatory factor analysis showed that the 21-item scale comprised three factors (autonomous motivation, controlled motivation and amotivation). The results of exploratory factor analysis showed the factor loading ranged from 0.602 to 0.888. Three factors explained 60.462% of the total variance. The results of confirmatory factor analysis showed an adequate model fit (χ²/df = 1.932, GFI = 0.908, AGFI = 0.885, NFI = 0.907, NNFI = 0.946, CFI = 0.952, IFI = 0.953, RMR = 0.048, RMSEA = 0.052). The Cronbach’s α for the scale was 0.903. The item-level content validity index (I-CVI) was 0.890 ~ 1.000, scale-level content validity index (S-CVI) was 0.983. Conclusion The help-seeking motivation scale for patients with schizophrenia has excellent psychometric properties. This scale may be a reliable measure for assessing help-seeking motivation in schizophrenia.