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Intercultural Validation of the Mindful Self-Care Scale—Rasch and Factor Analysis of 16 Studies Representing Five Continents

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Abstract

Objectives

Between 2012 and 2017, the Mindful Self-Care Scale (MSCS) was crafted and refined through a rigorous, evidence-based process. From 2017 to 2023, the instrument was validated across an array of cultural contexts. Despite these promising results, no research has consolidated item-level data to evaluate the psychometrics of the measure across various cultures. This study sought to examine the intercultural validity of the MSCS.

Methods

Retrospective instrument meta-analysis with Rasch modeling, factor analysis, and data drawn from 16 studies among five continents, Asia, Australia, Europe, South America, and North America (n = 5,658).

Results

Rasch and Factor Analysis indicated that measurement properties of the MSCS were reliable and valid in all 16 studies. The MSCS (33-item) showed good internal structure, validity, and invariance, to support generalizability of its scores in varied cultural settings. The Brief-MSCS (24-item) had a stronger internal structure with parsimony for well-being applications.

Conclusions

The MSCS (33-item and 24-item) were both reliable and valid among culturally and occupationally varied samples. With wide factorial scope and proven psychometric robustness, the MSCS serves as a useful tool for assessing mindful self-care preferences and values across heterogeneous ethnic, cultural, and occupational landscapes. Rasch and invariance testing further supported the human needs-based self-care theory used to operationalize the MSCS. The only negative item in the measure (PC6), was not adding value and could be removed. Future research should investigate mind-body practice in self-care and their relationship to other mindfulness constructs.

Preregistration

This study is not preregistered.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  • Brown, T. A. (2006). Confirmatory Factor Analysis for Applied Research. The Guilford Press.

    Google Scholar 

  • Burner, L. R., & Spadaro, K. C. (2022). Self-care skills to prevent burnout: A pilot study embedding mindfulness in an undergraduate nursing course. Journal of Holistic Nursing. https://doi.org/10.1177/08980101221117367

  • Chan, K. K. S., Tsui, J., & Tang, A. (2023). Longitudinal impact of self-compassion and psychological flexibility on mental illness recovery: The mediating roles of self-stigma and mental health service engagement. Mindfulness, 14(5), 1125–1134. https://doi.org/10.1007/s12671-023-02127-2

    Article  Google Scholar 

  • Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834

    Article  Google Scholar 

  • Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5

    Article  Google Scholar 

  • Cook-Cottone, C., LaVigne, M., Guyker, W., Travers, L., Lemish, E., & Elenson, P. (2017). Trauma-informed yoga: An embodied, cognitive-relational framework. International Journal of Complementary & Alternative Medicine, 9(1), 00284. https://doi.org/10.15406/ijcam.2017.09.00284

  • Cook-Cottone, C. P. (2015). Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care. Body Image, 14, 158–167. https://doi.org/10.1016/j.bodyim.2015.03.004

    Article  PubMed  Google Scholar 

  • Cook-Cottone, C. P. (2020). Embodiment and the treatment of eating disorders: The body as a resrouce in recovery. NE Norton.

    Google Scholar 

  • Cook-Cottone, C. P., & Guyker, W. M. (2018). The development and validation of the Mindful Self-Care Scale (MSCS): An assessment of practices that support positive embodiment. Mindfulness, 9(1), 161–175. https://doi.org/10.1007/s12671-017-0759-1

  • Depner, R. M., Cook-Cottone, C. P., & Kim, S. (2021). Structural relationship between mindful self-care, meaning made, and palliative worker’s quality of life. International Journal of Stress Management, 28(1), 74–87. https://doi.org/10.1037/str0000209

    Article  Google Scholar 

  • Epskamp, S. (2014). semPLOT: Path diagrams and visual analysis of various SEM packages’ output. http://github.com/SachaEpskamp/semPLOT.

    Google Scholar 

  • Figley, C. R. (1986). Trauma and its wake Volume II: Traumatic stress theory, research, and intervention (1st ed.). Routledge.

    Google Scholar 

  • Figley, C. R. (1996). Review of the compassion fatigue self-test. In B. H. Stamm (Ed.), Measurement of Stress, Trauma, and Adaptation (pp. 127–130). Sidran Press.

    Google Scholar 

  • Garcia, A. C. M., Ferreira, A., Silva, L., Conceição, V., Nogueira, D., & Mills, J. (2022a). Mindful self-care, self-compassion, and resilience among palliative care providers during the COVID-19 pandemic. Journal of Pain and Symptom Management, 64(1), 49–57. https://doi.org/10.1016/j.jpainsymman.2022.03.003

  • Garcia, A. C. M., Silva, L. S. R., Ferreira, A. C. G., Monteiro da Conceição, V., & Mills, J. (2022b). Translation, cultural adaptation, and validation of the mindful self-care scale among Brazilian palliative care providers. Palliative & Supportive Care, 20(6), 839–845. https://doi.org/10.1017/S1478951521001802

  • Goetz, C., Lemetayer, F., & Rat, A. (2013). Item reduction based on rigorous methodological guidelines is necessary to maintain validity when shortening composite measurement scales. Journal of Clinical Epidemiology, 66, 710–718. https://doi.org/10.1016/j.jclinepi.2012.12.015

    Article  PubMed  Google Scholar 

  • Halady, E., & Cook-Cottone, C. (2023). Mindful self-care, coping, and meaning in life: An examination of the Professional Quality of Life and well-being among individuals who support and provide services to refugees. Psychological Trauma Theory Research Practice and Policy. https://doi.org/10.1037/tra0001502

  • Hotchkiss, J. T. (2018). Mindful self-care and secondary traumatic stress mediate a relationship between compassion satisfaction and burnout risk among hospice care professionals. American Journal of Hospice & Palliative Medicine, 35(8), 1099–1108. https://doi.org/10.1177/1049909118756657

  • Hotchkiss, J. T., & Cook-Cottone, C. P. (2019). Validation of the Mindful Self-Care Scale (MSCS) and development of the Brief-MSCS among hospice and healthcare professionals: a confirmatory factor analysis approach to validation. Palliative & Supportive Care, 17(6), 628–636. https://doi.org/10.1017/S1478951519000269

    Article  Google Scholar 

  • Hotchkiss, J. T., & Cook-Cottone, C. P. (2023). The Mindful Helping and Self-Care model—Mindful self-care and quality of life among a racially-balanced sample of helping professionals. International Journal of Yoga Therapy. https://doi.org/10.17761/2023-D-22-00001

  • Hotchkiss, J. T., & Lesher, R. (2018). Factors predicting burnout among chaplains: compassion satisfaction, organizational factors, and the mediators of mindful self-care and secondary traumatic stress. The Journal of Pastoral Care & Counseling, 72(2), 86–98. https://doi.org/10.1177/1542305018780655

    Article  Google Scholar 

  • Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

    Article  Google Scholar 

  • Hughes, S., Haroon, S., Subramanian, A., McMullan, C., Aiyegbusi, L., Turner, G., Jackson, L., Davies, E., Frost, C., McNamara, G., Price, G., Matthews, K., Camaradou, J., Ormerod, J., Walker, A., & Calvert, M. (2022). Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis. BMJ, 377, e070230. https://doi.org/10.1136/bmj-2022-070230

  • Jiang, X., Topps, A. K., & Suzuki, R. (2021). A systematic review of self-care measures for professionals and trainees. Training and Education in Professional Psychology, 15(2), 126–139. https://doi.org/10.1037/tep0000318

    Article  Google Scholar 

  • Kroshus, E., Hawrilenko, M., Tandon, P., Browning, A., Steiner, M., & Christakis, D. (2023). Structural inequities in self-compassion and parental burnout. Mindfulness, 14(5), 1192–1203. https://doi.org/10.1007/s12671-023-02104-9

    Article  Google Scholar 

  • Marsh, H. W., Hau, K.-T., & Wen, Z. (2004). In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Structural Equation Modeling, 11(3), 320–341. https://doi.org/10.1207/s15328007sem1103_2

    Article  Google Scholar 

  • Masters, G. N., & Wright, B. D. (1982). The partial credit model. In Handbook of Modern Item Response Theory (pp. 101–121). Springer. https://doi.org/10.1007/978-1-4757-2691-6_6

    Chapter  Google Scholar 

  • McDonald, R. P. (1999). Test theory: A unified treatment. Psychology Press. https://doi.org/10.4324/9781410601087

    Book  Google Scholar 

  • Medvedev, O., & Krägeloh, C. (2023). Harnessing artificial intelligence for mindfulness research and dissemination: Guidelines for authors. Mindfulness, 14(5), 1019–1020. https://doi.org/10.1007/s12671-023-02155-y

    Article  Google Scholar 

  • Medvedev, O. N., Siegert, R., Feng, X., Billington, R., Jang, J., & Krägeloh, C. U. (2016). Measuring trait mindfulness: How to improve the precision of the Mindful Attention Awareness Scale using a Rasch model. Mindfulness, 7(2), 384–395. https://doi.org/10.1007/s12671-015-0454-z

  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & and the PRISMA Group. (2009). Reprint—Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA statement. Physical Therapies, 89(9), 873–880. https://doi.org/10.1093/ptj/89.9.873

    Article  Google Scholar 

  • Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., Bouter, L. M., & de Vet, H. C. W. (2010). The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: An international Delphi study. Quality of Life Research, 19(4), 539–549. https://doi.org/10.1007/s11136-010-9606-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Montero-Marin, J., Kuyken, W., Crane, C., Gu, J., Baer, R., Al-Awamleh, A. A., Akutsu, S., Araya-Véliz, C., Ghorbani, N., Chen, Z. J., Kim, M.-S., Mantzios, M., Rolim Dos Santos, D. N., Serramo López, L. C., Teleb, A. A., Watson, P. J., Yamaguchi, A., Yang, E., & García-Campayo, J. (2018). Self-compassion and cultural values: A cross-cultural study of self-compassion using a multitrait-multimethod (MTMM) analytical procedure. Frontiers in Psychology, 9, 2638. https://doi.org/10.3389/fpsyg.2018.02638

    Article  PubMed  PubMed Central  Google Scholar 

  • Muthen, B., & Asparouhov, T. (2013). BSEM measurement invariance analysis. Mplus Web Notes, 17, 1–48. https://www.statmodel.com/examples/webnotes/webnote17.pdf

    Google Scholar 

  • Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027

    Article  Google Scholar 

  • Neff, K. D., Tóth-Király, I., Knox, M. C., Kuchar, A., & Davidson, O. (2021). The Development and Validation of the State Self-Compassion Scale (Long-and Short Form). Mindfulness, 12(1), 121–140.

    Article  Google Scholar 

  • OpenAI. (2023). ChatGPT (May 28 version) [Large language model]. https://chat.openai.com/chat

  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

    Article  PubMed  PubMed Central  Google Scholar 

  • Schmitt, N., & Ali, A. A. (2015). The practical importance of measurement invariance. Routledge.

    Google Scholar 

  • Stamm, B. H. (2010). The concise ProQOL manual, ProQOL Version 5. http://www.proqol.org/

  • Streets, F. J., & Hotchkiss, J. T. (2022). US mainline clergy well-being and self-care study. Under Review

  • Terwee, C. B., Mokkink, L. B., Knol, D. L., Ostelo, R. W. J. G., Bouter, L. M., & de Vet, H. C. W. (2012). Rating the methodological quality in systematic reviews of studies on measurement properties: A scoring system for the COSMIN checklist. Quality of Life Research, 21(4), 651–657. https://doi.org/10.1007/s11136-011-9960-1

    Article  PubMed  Google Scholar 

  • Varan, D. (2022). Mediator Roles of Resilience on the Link Between Mindful Self-Care and Psychological Well-Being. Istanbul Kent University.

    Google Scholar 

  • Wong, M. Y. C. (2020). Translation and validation of the Mindful Self-Care Scale—Chinese version: A pilot study. Psych, 2(4), 338–346. https://doi.org/10.3390/psych2040025

    Article  Google Scholar 

  • Wong, M. Y. C., Chung, P. K., & Leung, K. M. (2022). Psychometric properties of Chinese translated body compassion scale (BCS) among Hong Kong adolescents. Journal of Exercise Science and Fitness, 20(1), 54–61. https://doi.org/10.1016/j.jesf.2021.10.001

    Article  PubMed  Google Scholar 

  • Wright, B. D., & Linacre, J. (1994). Reasonable mean-square fit values. Transactions of the Rasch measurement SIG American educational research association. Rasch Measurement Transaction, 8, 370–382. https://www.rasch.org/rmt/rmt83b.htm

    Google Scholar 

  • Yang, Z., Chen, F., Liu, S., Dai, M., & Zhang, H. (2021). Psychometric properties of the Chinese version of the brief-Mindful Self-Care Scale: A translation and validation study. Frontiers in Psychology, 12, 715507. https://doi.org/10.3389/fpsyg.2021.715507

  • Zeb, H., Arif, I., & Younas, A. (2022). Mindful self-care practice of nurses in acute care: A multisite cross-sectional survey. Western Journal of Nursing Research, 44(6), 540–547. https://doi.org/10.1177/01939459211004591

    Article  Google Scholar 

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Acknowledgements

We wish to acknowledge other researchers who provided Mindful Self-Care item-level data, in addition to the authors of this study, including Rachel Depner, Dilara Varan, Lindsay Burner, Hussan Zeb, Frederick Streets, Ahtisham Younas, Zhen Yang, and Huijun Zhang.

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Authors and Affiliations

  1. Cornerstone University, Grand Rapids, MI, USA

    Jason T. Hotchkiss

  2. University at Buffalo, State University of New York, Albany, USA

    Catherine P. Cook-Cottone & Wendy Guyker

  3. The Education University of Hong Kong, Ting Kok, Hong Kong

    Ming Yu Claudia Wong

  4. Federal University of Alfenas, Alfenas, Brazil

    Ana Cláudia Mesquita Garcia

Authors
  1. Jason T. Hotchkiss
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  2. Catherine P. Cook-Cottone
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  3. Ming Yu Claudia Wong
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  4. Wendy Guyker
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  5. Ana Cláudia Mesquita Garcia
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Contributions

Jason Hotchkiss: conceptualization; data curation; formal analysis; project administration; methodology; validation; writing—original draft; writing—review and editing. Catherine Cook-Cottone: conceptualization, data curation, resources, supervision, writing—reviewing and editing. Claudia Ming Yu Wong: data curation, formal analysis, validation, visualization, writing—review and editing. Wendy Guyker: data curation, resources, validation, writing—reviewing and editing. Ana Claudia Mesquita Garcia: data curation, investigation, validation, writing—original draft.

Corresponding author

Correspondence to Catherine P. Cook-Cottone.

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Ethics Statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of Cornerstone University on 17 July 2021.

Informed Consent

This study used retrospective data only. However, informed consent was obtained from all participants included in this meta-analysis.

Conflict of Interest

The author declares no competing interests.

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Hotchkiss, J.T., Cook-Cottone, C.P., Wong, M.Y.C. et al. Intercultural Validation of the Mindful Self-Care Scale—Rasch and Factor Analysis of 16 Studies Representing Five Continents. Mindfulness 14, 2055–2072 (2023). https://doi.org/10.1007/s12671-023-02196-3

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