Development and Validation of "The Nottingham Adjustment Scale Japanese Version" which Measures Psychological Adjustment to the Visual Impairment

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  • Suzukamo Yoshimi
    Department of Epidemiology and Health Care Research, Graduate School of Medicine and Public Health, Kyoto University
  • Kumano Hiroaki
    Department of Stress Science and Psychosomatic Medicine, Granduate School of Medicine, The University of Tokyo
  • Iwaya Tsutomu
    Department of Rehabilitation Medicine for Persons with Physical Disability, Tohoku University School of Medicine

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Other Title
  • 視覚障害への心理的適応を測定する尺度 : The Nottingham Adjustment Scale 日本語版の開発
  • シカク ショウガイ エ ノ シンリテキ テキオウ オ ソクテイ スル シャクド The Nottingham Adjustment Scale ニホンゴバン ノ カイハツ

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The purpose of this study was to develop the Japanese version of "the Nottingham Adjustment Scale(NAS)" which measured psychological adjustment to the visual impairment, and to assess its validity and reliability. The NAS is composed of 7 psychological subscales including anxiety-depression, self-esteem, attitude to disability, locus of control, acceptance of disability, self-efficacy and attributional style. First, we translated the original questionnaire into Japanese after obtaining the author's approval. Next, We translated the Japanese rendering into English again, and asked the author to confirmed it. This Japanese version was called "the NAS-J(the Nottingham Adjustment Scale Japanese version)". The items of the NAS-J were selected through the pretest with sighted people. Then we conducted a survey of visually impaired people who were engaging in vocational training in 5 national rehabilitation centers. A total of 336 persons were asked to fill out the NAS-J and the SF-36(Health-related QOL scale), and primary diseases inducing visual impairment, eyesight, and the number of years since the present sight became stable were also inquired. As a result of factor analysis, 31 items were retained and 7 factors consistent with the original scale were extracted(51.6% of total variance). Each items contributed 0.5 or more loadings to a supposed factor, and contributed 0.5 or less loadings to the other factors. These results showed the sufficient construct validity, convergent validity and discriminant validity. The subscales of anxiety-depression and self-esteem significantly correlated with most subscales of the SF-36 in sighted people, and thus the concurrent validity was shown. The scores of visually impaired people were lower than those of sighted people in 4 subscales such as anxiety-depression, self-esteem, attitude, and locus of control as the earlier study, and the discriminant validity was confirmed. The reliability coefficients of all subscales were more than 0.7 except that of locus of control. Because the number of items of locus of control was rather small, the reliability coefficients of the subscale was permissible. These results showed the sufficient validity and reliability of the NAS-J as the scale which measures the psychological adjustment to visual impairment. We are constructing the structure model of the psychological adjustment and investigating the effects of the adjustment to handicap. We will publish these results on another occasion.

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