Cross-cultural adaptation and validation of the treatment adherence questionnaire for Chinese patients with schizophrenia

Treatment adherence is crucial in managing schizophrenia, as nonadherence leads to relapse and increased societal burden. However, validated tools for assessing treatment adherence in Chinese patients with schizophrenia are lacking. This study aimed to adapt the Treatment Adherence Questionnaire (TAQ) for the Chinese population and evaluate its psychometric properties. A cross-sectional study was conducted with 252 Chinese patients diagnosed with schizophrenia. The TAQ was culturally adapted, and its structural validity was assessed through item analysis, structural equation modeling, and multigroup confirmatory factor analysis. Reliability, convergent validity, and content validity were also examined. We enrolled 252 patients (mean age 46.69 years; 46.8 % female; 19.8 % married). The Treatment Adherence Questionnaire demonstrated a three-factor structure. Content validity was excellent (0.960), and scale scores were positively correlated with the Medication Adherence Rating Scale, supporting construct validity. The questionnaire demonstrated high internal consistency, with Cronbach’s alpha of 0.931 and split-half reliability of 0.842. Group confirmatory factor analysis confirmed measurement invariance across gender, age, and disease course at the scalar level. The Chinese version of the TAQ is a reliable and valid tool for assessing treatment adherence in Chinese patients with schizophrenia. Its use could improve clinical assessment and support better management outcomes for this population.