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Validity and reliability of the ten-item Connor–Davidson Resilience Scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore

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Abstract

We aimed to assess the validity and reliability of the ten-item Connor–Davidson Resilience Scale (CD-RISC10) in patients with axial spondyloarthritis (axSpA) in Singapore. We used cross-sectional data from 108 patients with axSpA recruited from a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework. Face validity was assessed through cognitive debriefing interviews (CDIs). Internal consistency was assessed through Cronbach’s alpha. Test–retest reliability was assessed through intraclass correlation (ICC). Measurement error was assessed through smallest detectable change (SDC). Construct validity was assessed through six a priori hypotheses through correlation of the CD-RISC10 score with other patient-reported outcome measures. Structural validity was assessed using confirmatory factor analysis (CFA). Fit indices evaluated were root-mean-square error of approximation (RMSEA), comparative fit index (CFI), Tucker–Lewis index (TFI), and standardized root-mean-squared residual (SRMR). Ten patients completed the CDIs and face validity was supported. Among 108 patients (median age: 37(21–77), 81.5% males, 93.5% Chinese), the CD-RISC10 demonstrated good internal consistency (Cronbach’s alpha = 0.94), and excellent test–retest reliability [ICC = 0.964 (95% CI 0.937–0.980)]. SDC was calculated as 1.88. Construct validity was established by meeting five out of the six a priori hypotheses. Structural validity was supported as CFA confirmed a one-factor model, with adequate fit statistics after adding three covariances (RMSEA = 0.077; CFI = 0.975; TLI = 0.964; SRMR = 0.036). This study supports the CD-RISC10 as a valid and reliable measure of resilience for use in patients with axSpA.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Yu Heng Kwan, Amanda Ng and Ka Keat Lim are co-first authors.

Authors and Affiliations

  1. Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Yu Heng Kwan, Ka Keat Lim, Julian Thumboo & Truls Østbye

  2. Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore

    Amanda Ng & Eng Hui Chew

  3. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    Warren Fong, Jie Kie Phang, Nai Lee Lui, Julian Thumboo & Ying Ying Leung

  4. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Warren Fong & Ying Ying Leung

  5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Warren Fong, Julian Thumboo & Ying Ying Leung

  6. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore

    Chuen Seng Tan

Authors
  1. Yu Heng Kwan
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Contributions

YHK, TO, WF, and JT conceived and designed this study. JKP, AN, WF, NLL and YYL acquired the data for this study. AN, KKL and YHK performed the analyses and prepared the first draft of the manuscript. CST advised the statistical analyses. KKL, CST, EHC, and NLL interpreted the results. All authors read, revised critically, and approved the final manuscript.

Corresponding author

Correspondence to Yu Heng Kwan.

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Conflict of interest

The authors declare that there is no other conflict of interest to disclose.

Ethical approval

The SingHealth Centralised Institutional Review Board approved this research. All patients provided written informed consent to participate in this research.

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Kwan, Y.H., Ng, A., Lim, K.K. et al. Validity and reliability of the ten-item Connor–Davidson Resilience Scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore. Rheumatol Int 39, 105–110 (2019). https://doi.org/10.1007/s00296-018-4217-8

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  • DOI: https://doi.org/10.1007/s00296-018-4217-8

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