RESEARCH BYTES
Turkish Version of the Motivation for Changing Lifestyle
and Health Behavior for Reducing the Risk of
Dementia Scale
Jane R. von Gaudecker
In this issue of Journal of Neuroscience Nursing, Zehirlioglu
and colleagues
1
report the findings of the psychometric
testing of the Turkish version of Motivation for Changing
Lifestyle and Health Behavior for Reducing the Risk of
Dementia (MCLHB-DRR) scale. The article is an excel-
lent example of the procedures that are necessary when
translating a scale to a new language including psycho-
metric testing involved.
Study Purpose
The purpose of the study was to test the validity and
reliability of the Turkish version of the MCLHB-DRR
scale.
Significance
Dementia is a growing problem among the aging popu-
lation in Turkey, with no modifying treatment available
at this time. Prevention of dementia is possible with a
healthy lifestyle, but no study in Turkey has examined
the levels of knowledge and behavioral tendencies for
the purpose of reducing the risk of dementia. Further-
more, there is no tool that can be used to measure the
awareness, beliefs, attitudes, and motivation with regard
to changing lifestyle to prevent dementia.
Methods
The participants (N = 220) were 40 years or older recruited
from a primary clinic using convenience sampling.
The participants were literates, spoke and understood
Turkish, and agreed to participate voluntarily in the
study. Individuals with dementia or psychiatric disorders,
and visual and/or hearing impairments were excluded
from the study.
The Scale
The MCLHB-DRR, which was designed to evaluate be-
liefs and attitudes concerning lifestyle and behavioral
changes in dementia, was developed in Australia. The
scale has 27 items, with 7 subscales including perceived
susceptibility, perceived severity, perceived benefits, per-
ceived barriers, cues to action, general health motivation,
and self-efficacy. The items are rated on a 5-point Likert
scale (1, strongly disagree; 5, strongly agree), and the total
score ranges from 27 to 135. Higher score indicates high
motivation to change lifestyle and health behaviors to
reduce the risk of dementia.
Development of the Turkish Version of
MCLHB-DRR
The scale was translated from English to Turkish and back-
translated. Clarity was ensured by comparing the origi-
nal version with the translated version and consulting
with the author of the original version about items that
were unclear.
Content validity was confirmed by experts in psy-
chometric analysis and dementia care. The experts'
opinions regarding scale-level content validity (S-CVI)
and item-level content validity index (I-CVI) were
ranked using Davis Technique.
After administering the MCLHB-DRR scale to 34 individ-
uals, within 2 to 3 weeks, the individuals were reevaluated
to assess the test-retest reliability. The internal consistency
reliability was evaluated using a paired t test. After lan-
guage and content validity was confirmed, a pilot study
was conducted with 20 individuals.
Statistical Analysis
The level of concordance of these rankings was analyzed
using a nonparametric Kendall W analysis. To assess for
construct validity, confirmatory factor analysis was used,
and Pearson χ
2
, degree of freedom, root mean square
error of approximation, goodness-of-fit index, compar-
ative fit index, and normal fit index were used for anal-
ysis purposes. The Cronbach α value was calculated for
reliability analysis.
Results
The mean (SD) age of 220 individuals who participated in
the study was 57.64 (12.02) years. Most of them were mar-
ried (75%), women (69.5%), and retired or unemployed
(62.7%); 63.6% reported their income to equal to their ex-
penses, 69.6% were living with their spouse and children,
and 51.8% were living with at least 1 chronic disease.
There were no significant differences between scores
given by experts for each item: Kendall W = 0.223,
P = .06. The lower limit of acceptability for a CVI is
0.80; an I-CVI of 0.78 or higher and an S-CVI of 0.90
or higher are the minimum acceptable indices. The
CVI of the MCLHB-DRR Turkish version was 0.99, the
I-CVIs for the 27 items were between the ranges of
0.88 and 1, the S-CVI for 6 subscales was 1.0, and it
Questions or comments about this article may be directed to
Jane R. von Gaudecker, PhD RN, at jvongaud@iu.edu. She is an Assis-
tant Professor, Indiana University School of Nursing, Indianapolis, IN.
The author declares no conflicts of interest.
Copyright © 2019 American Association of Neuroscience Nurses
DOI: 10.1097/JNN.0000000000000453
Volume 51 & Number 3 & June 2019 127
Copyright © 2019 American Association of Neuroscience Nurses. Unauthorized reproduction of this article is prohibited.