Patient Preference and Adherence (Aug 2022)
Valid and Convenient Questionnaire Assessment of Chinese Body Constitution: Item Characteristics, Reliability, and Construct Validation
Abstract
Taoying Lu,1– 3 Jingwen Yan,4 Jianfang Chang,5 Jianxiong Cai,1– 3 Lingjia Yin,1,3,6 Jiamin Yuan,1,7 Li Huang,1,7 Yingshuai Li,8 Minghua Bai,9 Kit-Tai Hau,5 Darong Wu,1– 3 Zhimin Yang1,7 1State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 3Program for Outcome Assessment in TCM, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China; 4The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 5Department of Education Psychology, The Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China; 6Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; 7Health Construction Administration Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China; 8National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 9School of Traditional Chinese Medicine/National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of ChinaCorrespondence: Darong Wu; Zhimin Yang, State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Guangzhou, 510120, People’s Republic of China, Tel +86 13808869436 ; +86 13822296363, Email [email protected]; [email protected]: Body constitution is a fundamental concept in traditional Chinese medicine (TCM) for clinical diagnosis, treatment of illness, and community-based health promotion. Clinical assessment of patients’ body constitutions, however, has never been easy and consistent, even by well-trained clinicians and TCM practitioners. Therefore, questionnaires such as the popular Constitution in Chinese Medicine Questionnaire (CCMQ) can be an appealing and convenient assessment alternative. The present research borrowed advanced methodologies for questionnaire development in psychology and other social sciences to examine the performance of the CCMQ in terms of (i) the strength of relations of each item with its designated constitution, (ii) the reliabilities of each constitution, and (iii) the overall 9-constitution structure. This research provided empirical evidence to support the use of the CCMQ and proposed directions for refinement in future revisions of the CCMQ or similar measures.Methods: A total of 1571 volunteers from three villages in southern China participated in the CCMQ survey. The item characteristics, reliabilities, interconstitution correlations, and confirmatory factor analysis of the 9-body-constitution structure were examined.Results: The results generally supported the appropriateness of the clinical observations (the questionnaire items) and the CCMQ 9-constitution classification structure. Nevertheless, some relatively weaker items, item pairs with similar meanings, and highly overlapping constitutions were identified for future CCMQ revisions.Conclusion: The CCMQ measured the 9 constitutions efficiently and with reasonably good reliability and construct validity. Given the various challenges to assessing TCM body constitutions even by experienced clinicians, the CCMQ provides an appealing alternative to measure the Chinese body constitutions of healthy participants in large-scale research or community health promotion programs. The present study also demonstrated how advanced methodologies in social sciences can help validate and refine the CCMQ and similar complementary medicine measures.Keywords: Chinese constitution, body constitution, CCMQ, Constitution in Chinese Medicine Questionnaire, reliability, construct validity
