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Title: Holistic health status questionnaire : developing a measure from a Hong Kong Chinese population
Authors: Chan, CW 
Wong, FKY 
Yeung, SM
Sum, F
Keywords: Factor analysis
Holistic health
Holistic Health Status Questionnaire
Hong Kong Chinese
Instrument development
Issue Date: 2016
Publisher: BioMed Central
Source: Health and quality of life outcomes, 2016, v. 14, 28, p. 1-12 How to cite?
Journal: Health and quality of life outcomes 
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.
EISSN: 1477-7525
DOI: 10.1186/s12955-016-0416-8
Rights: © 2016 Chan et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
The following publication Chan, C. W., Wong, F. K. Y., Yeung, S. M., & Sum, F. (2016). Holistic health status questionnaire : developing a measure from a Hong Kong Chinese population. Health and Quality of Life Outcomes, 14, 28, 1-12 is available at
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