Psychometric validation of the Multidimensional Acceptance of Loss Scale

Objective: To develop and field test the Multidimensional Acceptance of Loss Scale to measure disability acceptance based on the four value changes identified by Beatrice Wright. Design: Quantitative descriptive design using exploratory factor analysis to determine the factorial validity of the Multidimensional Acceptance of Loss Scale. Setting: The Canadian Paraplegic Association. Subjects: One hundred and sixty-one members of the Alberta, Saskatchewan, Nova Scotia and Manitoba chapters of the Canadian Paraplegic Association were recruited for the current study. Results: A four-factor structure accounting for 50% of the total variance was found for the Multidimensional Acceptance of Loss Scale. The internal consistency reliability coefficients (Cronbach's alpha) for the four factors ranged from 0.80 to 0.88. Three clusters of participants with high, moderate and low disability acceptance were identified based on their profiles of Multidimensional Acceptance of Loss Scale subscale scores using cluster analysis. MANOVA results indicated that participants in the three clusters significantly differed on self-esteem, F(2, 154) = 19.78, P < 0.001 and quality of life, F(8, 236) = 5.16, P < 0.001. Participants with high Multidimensional Acceptance of Loss Scale scores have higher self-esteem and quality of life scores than those with lower scores. Conclusion: The Multidimensional Acceptance of Loss Scale was found to measure the four value changes in Beatrice Wright's disability acceptance theory in a sample of Canadians with spinal cord injuries. It demonstrated good internal consistency reliability and construct validity.