Development of a Scale Measuring Emotional Catharsis through Illness Narratives

Abstract

Objective: This study intended to construct a scale measuring the catharsis effect on medical professionals or students through illness narratives (ECS-IN). Methods: After a systematic literature review and panel discussion, the researchers conducted a pilot study with a sample of seven hundred and eighty-two randomly selected healthcare students and providers in Taiwan to examine psychometric properties using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for item derivation and factor extraction. The researchers also tested the validities and reliabilities of the ECS-IN scale to confirm its feasibility. Results: the EFA yielded 29 items and three factors: “emotional identification as self-healing” (12 items; 55.500% of variance explained), “emotional release for compensation” (10 items; 7.465% of variance explained), and “emotional adjustment for intellectual growth” (7 items; 4.839% of variance explained). The CFA yielded an 18-item, three-factor model with satisfactory fit to the data, where the χ2/df ratio = 1.090, Tucker–Lewis index (TLI) = 0.996, comparative fit index (CFI) = 0.997, and root mean square of approximation (RMSEA) = 0.020. The convergent validity and discriminant validities also demonstrated the feasibility of the ECS-IN scale. For the first version of the ECS-IN scale (29 items), the Cronbach’s alphas for the three factors and the overall scale were in the range between 0.912 and 0.971; for the reduced version of the scale (18 items), the Cronbach’s alphas and composite reliabilities were in the range of 0.888–0.946 and 0.890–0.968. Conclusion: The findings proved that the ECS-IN could be a reliable and valid instrument to assess participants’ emotional catharsis through illness narratives.

Narrative medicine and humanities for health professions education: an experimental study

“…Emotional catharsis is the process of strongly expressing repressed or immediate negative emotions, such as pity, fear, stress, and anxiety, in order to release hostility or trauma in the mind, and thus generate a certain positive emotion or change in one’s life [ 33 , 34 ]. In this study, a short form emotional catharsis (ECS-IN) scale [ 35 ] was used to measure the emotional catharsis level of students, with 9 indicating ‘strongly agree’ and 1 indicating ‘strongly disagree.’ Students receiving higher scores on the ECS-IN were interpreted as having stronger emotional catharsis. The 18-item ECS-IN, with overall Cronbach’s α 0.946, included three factors: ‘emotional identification as self-healing’ (7 items; factor loadings: 0.747–0.886; Cronbach’s α: 0.930), ‘emotional release for compensation’ (7 items; factor loadings: 0.724–0.814; Cronbach’s α: 0.907), and ‘emotional adjustment for intellectual growth’ (4 items; factor loadings: 0.688–0.899; Cronbach’s α: 0.888).…”

“…The phrase ‘emotional release for compensation’ refers to dealing with inner anxiety, fear, or negative emotions to unleash negative feelings and thus find relief via illness narratives. The “emotional adjustment for intellectual growth’ refers to the use of illness narratives to deal with ambivalences in clinical or healthcare settings so as to regulate emotions and thus reach intellectual growth [ 35 , 36 ].…”

“…The 18-item ECS-IN scale also showed acceptable convergent validities, and the discriminant validities were proven [ 35 ]. The ECS-IN scale has a maximum score of 162 and a minimum score of 18.…”

“…The ECS-IN scale has a maximum score of 162 and a minimum score of 18. The higher the score, the stronger the emotional catharsis a participant had [ 35 ]. Based on the present sample, the Cronbach’s α for the whole scale and the three factors were 0.97, 0.95, 0.94, and 0.95, respectively.…”