Acceptance of loss after an adult-onset disability: Development and psychometric validation of the Multidimensional Acceptance of Loss Scale.

摘要

The Multidimensional Acceptance of Loss Scale (MALS) emerged out of concerns expressed by Keany and Glueckauf (1999) of the methodological flaws of Linkowski's (1971) Acceptance of Disability scale. Development of the MALS items involved a comprehensive review of the literature, consultation with Dr. Beatrice Wright, and the assistance of a panel of experts. Psychometric validation of the MALS included factor analysis and correlating MALS factor scores with two constructs, self-esteem and quality of life. Participants (n = 161) were drawn from the Canadian Paraplegic Association, of which 124 (77%) were male, 37 (23%) were female, the mean age of all participants was 46.9 years (SD = 15.5 years), and the primary disability was spinal cord injury (95%, n = 153).;A factor analysis supported a 42-item MALS and an underlying factorial structure of four value domains, enlarging the scope of values, containing the effects of disability, subordinating physique relative to other values, and transforming comparative-status values into asset values. Participants were clustered into one of three disability acceptance style groups (High, Medium, and Low) based on their MALS factor scores. A significant MANOVA was found among the three groups on the four World Health Organization Quality of Life-Brief Version domains, Wilks's Lambda = .72, F (8, 236) = 5.16, p = .000. Multiple linear regression analyses resulted also indicated that all four MALS factors significantly predicted Self-Esteem Scale scores, R2 = .31, adjusted R2 = .29, F (4, 156) = 17.16, p = .000. The results lend support to the construct validity of the MALS.