ArticleFrontiers in psychiatry2026
Psychometric validation of the Chinese Warwick-Edinburgh mental well-being scale in patients with heart failure or myocardial infarction: evidence from classical test theory and item response theory.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Positive mental well-being is increasingly recognized as an important component of cardiovascular care, particularly among patients with heart failure or myocardial infarction. However, validated Chinese-language instruments for assessing positive mental well-being in this population remain limited. Objective: This study evaluated the psychometric properties of the Chinese-language 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in patients with heart failure or myocardial infarction. Methods: In this cross-sectional validation study, 392 patients with heart failure or myocardial infarction completed the Chinese-language WEMWBS. Construct validity was examined using exploratory and confirmatory factor analyses. Convergent validity was assessed using factor loadings, composite reliability (CR), and average variance extracted (AVE), and criterion-related validity was evaluated using the 5-item World Health Organization Well-Being Index (WHO-5) as an external criterion. Internal consistency was estimated using Cronbach's α. Item-level performance was examined using item response theory under the graded response model. Results: The Chinese-language WEMWBS showed excellent internal consistency, with Cronbach's α = 0.961. The modified one-factor confirmatory factor model showed acceptable fit on most indices, with χ²/df = 2.68, CFI = 0.955, TLI = 0.944, RMSEA = 0.091, and SRMR = 0.038. Criterion-related validity was supported by a strong positive correlation with the WHO-5 (r = 0.746). Item response theory analyses indicated generally satisfactory item discrimination and ordered threshold parameters. Conclusions: The Chinese-language WEMWBS demonstrated satisfactory psychometric properties in patients with heart failure or myocardial infarction. These findings support its potential use as a patient-reported outcome measure for assessing positive mental well-being in this population. Longitudinal and intervention studies are needed to evaluate its responsiveness, predictive validity, and clinical utility in cardiovascular care.
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