Original Article

Hindi Translation and Validation of Scales

for Subjective Well-being, Locus of Control
and Spiritual Well-being
Sandeep Grover1, Devakshi Dua1

ABSTRACT for the Hindi version of WEMWBS, SWBS, scales is 0.92, 0.83, and 0.76 for WEMWBS,
and MHLC scales was 0.92, 0.83, and SWBS, and MHLC, respectively.

T
Background: Well-being and locus of 0.77, respectively. The Spearman–Brown
control have been important areas of he concept of well-being has
coefficient was 0.82, 0.63, and 0.63 for
research over the last few years. However, WEMWBS, SWBS, and MHLC, respectively. been of interest in psychologi-
limited information is available about As measured on the Centrality of cal research with varied foci and
the same from India, due to the lack Religiosity Scale (CRS), higher religiosity definitions. It focuses on the positive
of validated instruments in regional was associated with greater religious and aspects of life experiences. People equate
languages for the same.This research existential well-being. well-being with other constructs and use
aimed to translate, adapt, and validate the it interchangeably with alternative terms
Conclusion: The Hindi versions of
Warwick-Edinburgh Mental Well-being such as happiness, state of contentment,
WEMWBS, SWBS, and MHLC have good
Scale (WEMWBS), Spiritual Well-being
cross-language equivalence, internal wellness, etc. When it is equated with
Scale (SWBS), and Multidimensional Health consistency, and test–retest reliability. wellness, it suggests having good phys-
Locus of Control (MHLC) Scale in Hindi. It is expected that these validated scales ical and mental health.1
Methods: The scales were translated into will stimulate more research in this area, Many efforts have been made to define
Hindi by following the translation–back- focusing on evaluating the association of
subjective well-being (SWB). Diener et
translation methodology as specified by the clinical parameters along with well-being
and locus of control. al.2 defined it as “a person’s cognitive and
World Health Organization. Next, the Hindi
affective evaluations of his or her life.” It
versions of the scales were completed by Keywords: Validation, well-being, locus of
102 participants, and then, the participants is considered to have three components,
control
completed either the Hindi or the English that is, life satisfaction, positive effect,
version of the scales after 3–7 days. Key Messages: The Hindi versions of the and negative effect.3 A person is consid-
Warwick-Edinburgh Mental Well-being ered to have positive SWB if they have
Results: The Hindi versions of WEMWBS, Scale (WEMWBS), Spiritual Well-being high positive effect and life satisfaction,
MHLC, and SWBS have high cross- Scale (SWBS), and Multidimensional
language equivalence with the English with low negative effect. On the other
Health Locus of Control (MHLC) Scale have
version of the scale, both at the level good cross-language equivalence with the hand, if the person experiences a low level
of the individual items and the various English version. The test–retest reliability of happiness, has little satisfaction with
dimensions in all three scales, which was of all the three scales is high. Cronbach’s life, and experiences a high level of nega-
significant (P < 0.001). Cronbach’s alpha alpha for the Hindi version of all the three tive emotions such as anger, anxiety, and

Dept. of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
1

HOW TO CITE THIS ARTICLE: Grover S, Dua D. Hindi translation and validation of scales for subjective well-being, locus of control and
spiritual well-being. Indian J Psychol Med. 2021;43(6):508–515

Address for correspondence: Sandeep Grover, Dept of Psychiatry, Post Graduate Submitted: 9 May. 2020
Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: Accepted: 13 Aug. 2020
drsandeepg2002@yahoo.com Published Online: 31 Oct. 2020

Copyright © The Author(s) 2020

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative ACCESS THIS ARTICLE ONLINE
Commons Attribution- NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/)
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which permits non-Commercial use, reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open Access pages (https:// DOI: 10.1177/0253717620956443
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508 Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021

 Original Article

low mood, they are considered to have tigation was to evaluate the association (MHLC-A and MHLC-B) or in individu-
negative SWB.4 However, experts have of SWB, spiritual well-being, and locus als with a medical condition (MLHC-C).
emphasized that high SWB should not be of control with the level of religiosity, MHLC-A is the more commonly used
considered as synonymous with mental assessed by using the Centrality of Reli- health locus of control form and was
and psychological health, as the absence giosity Scale (CRS). translated for the purpose of this study.
of psychopathology is not an indicator of The MHLC scales were designed to as-
positive SWB5 and a person with mental Materials and Methods sess the control beliefs of a person with
illness can have positive SWB in the pres- This study was conducted at a tertia- regard to the factors that determine
ence of psychopathology.5 ry care centre, after due approval from their health status. The factors could be
In terms of various determinants of the Institutional Ethics Committee. A “internal” (i.e., residing in the person’s
SWB, literature suggests that positive cross-sectional study design was fol- own actions), “external” (i.e., dependent
SWB is associated with positive mental lowed, and the study included 102 partic- on the actions of other people), or chance
health, positive relationships, certain ipants selected by convenient sampling. factors. The MHLC-A form has 18 items
personality and temperament traits, The study participants were enrolled divided into three factors, that is, inter-
good social relations, genetic factors, en- during the period of April 2017 after seek- nal control, chance factors, and power-
vironmental factors, employment, mar- ing their written informed consent. They ful others in health beliefs. Each item
riage, age, culture, etc.6 included healthy subjects who agreed to is evaluated on a six-point Likert scale
Besides SWB, researchers have also de- complete the different versions (Hindi/ (strongly disagree, moderately disagree,
scribed the concept of spiritual well-being English) of the scales on two occasions slightly disagree, slightly agree, moder-
and described it to have two components, within a span of 3–7 days. ately agree, and strongly agree).
that is, religious well-being (RWB) and Only those subjects who reported to be SWBS7,8: This scale has 20 items, di-
existential well-being (EWB). The RWB free from any diagnosed mental illness vided into two subscales—the RWB and
evaluates one’s relationship with God, and any diagnosed chronic physical dis- EWB subscale. Each item is evaluated on
while the EWB evaluates one’s sense of ease were included. a six-point scale. Eight items of the scale
life purpose and life satisfaction.7,8 The sample size was calculated based are reverse-coded. The total WBS score is
The concept of locus of control refers upon the longest scale (SWBS), which calculated by adding the scores on all the
to the person’s belief about the extent to consists of 20 items. Although a factor items.A higher score suggests a higher
which they have control over things that analysis was not carried out, a sample spiritual well-being.
happen to them. The two overarching do- size of five times the number of items The CRS18: This scale has five theoret-
mains of locus of control include internal in the scale with the highest number of ically defined dimensions of religiosity,
and external locus of control. An addition- items was considered. that is, public practice, private practice,
al component of locus of control, which The instruments that were translated religious experience, ideology, and the
has been described/defined in some of the and adapted were the WEMWBS, SWBS, intellectual dimension. The total score of
scales, includes “chance factors.”9 and the Multi-Dimensional Health Locus CRS is considered to represent the total
Research on the concept of SWB is of Control Scale. Additionally, the CRS, religious life of the person. The scale has
lacking, and there is limited research on which has been validated in India16 was been used in the global religion monitor,
the locus of control in the Indian con- used for evaluating concurrent validity. which was carried out in 21 countries,
text.10,11 When someone looks at the con- WEMWBS17: This scale was developed with India being one of the countries.
cept of SWB in the Indian context, it can by a group of researchers at the Universi- The 15-item version of CRS has been
be said that how people interpret their ties of Warwick and Edinburgh, with the translated and adapted in Hindi,15 and
health and the factors they attribute purpose of assessment of mental well-be- the Hindi version of the scale has Cron-
their health status to are very import- ing of adults in the United Kingdom. It bach’s alpha of 0.95, indicating good
ant. In India, many patients with physi- has 14 items that assess the SWB and test–retest reliability. The scale also has
cal and psychological illnesses attribute psychological functioning of the person high cross-language concurrence with
their illness to fate, karma, black magic, completing the scale. All the items are the English version.16
etc.12–15 Hence, there is a need to under- positively worded, and are rated on a
stand the determinants of SWB in the point Likert scale of 1–5, with better men- Process of Translation and
Indian context. tal well-being being indicated by higher
One of the major reasons for lack of scores. It is suggested that the scores are
Adaptation
research from India may be the unavail- stable over one week. A cut-off score of Translation of the scales was done by men-
ability of validated scales for assessment 50.7 is considered to be a cut-off indica- tal health professionals with proficiency
of these concepts in the Indian context. tor of good subjective mental well-being. in both the languages, that is, Hindi and
Accordingly, this research focused to Factor analysis of the scale had shown English, as per the methodology suggest-
translate, adapt, and validate the WEM- the existence of 1 factor. ed by the World Health Organization.19
WBS, SWBS, and Multidimensional MHLC Scales9: MHLC was developed Initially, each of these scales was trans-
Health Locus of Control (MHLC) Scale in for the assessment of health-related con- lated to Hindi by three mental health
Hindi. An additional focus of this inves- trol beliefs in the general population professionals. Then these were reviewed

Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021 509

 Grover and Dua

by another panel of three mental health of their caregivers, who were proficient in selected by convenient sampling. They
professionals, who compared the three Hindi, to evaluate the language and cultur- were requested to answer the question-
available Hindi versions and the English al appropriateness and to give suggestions naires as per the requirement. The par-
version of the scales. During the process to improve the scale further. These inputs ticipants were again approached after
of review of the Hindi versions, the trans- helped to refine the Hindi translation fur- a time frame of 4–7 days, and they were
lation that retained the original meaning ther. This Hindi version was back-translat- asked to complete either the Hindi ver-
and was able to express the meaning in the ed to English by bilingual mental health sion again (n = 61) or the English version
simplest way, was retained. If the experts professionals who were not familiar with (n = 41) of all three scales.
felt that the translations did not meet the these scales. The back-translations were
required criteria, they gave their inputs compared with the original English ver-
Statistical Analysis
and translated the item. The items that sion in terms of the meaning conveyed. Statistical Package for the Social Scienc-
required adaptation, in view of the Indian The back-translated versions were also es, 20th version (SPSS-20, IBM) was used
culture, were suitably modified. During sent to the authors of the original scales for to analyse the data. Simple descriptive
the process of translation, an effort was their view. Based on all the inputs, if any of statistics involved the calculation of
made to keep the language simple, with- the items was not appropriate, the Hindi mean and standard deviation for contin-
out changing the meaning of the “stem/ translation was further modified and a fi- uous variables and frequency along with
item” of the scales. Additionally, an effort percentages for the categorical variables.
nal version was developed.
was made to address the issues related to Cronbach’s alpha was used to assess the
semantics and cultural factors. Based on Process of Evaluation of internal consistency of the Hindi version
these inputs, a draft Hindi version of the of the scales and the Spearman–Brown
scale was developed. The draft Hindi ver-
Psychometric Properties coefficient was used to estimate the split-
sion was given to 10 healthcare workers, First, the Hindi version, so developed, half reliability of the Hindi versions of
five patients with mental illnesses, and five was handed over to 102 healthy subjects the scale. Test–retest reliability of the

TABLE 1.

Psychometric Properties of the Warwick-Edinburgh Mental Well-Being Scale

Item First Assess- Second As- Second As- Pearson Intra-class 95% Intra-class 95%
ment sessment sessment Correlation Correlation Confidence Correlation Confidence
(Hindi Ver- (Hindi Ver- (English Coefficient for Coefficient Intervals Coefficient Intervals
sion) sion) Version) Hindi–English Hindi–Hin- for Hindi–
n = 102 n = 61 n = 41 versions di Versions English
Mean Mean Mean (n = 41) (n = 61) Versions
(SD) (SD) (SD) (n = 41)
I’ve been feeling optimis- 3.77(1.18) 3.58(1.29) 3.78(1.17) 0.94*** 0.95*** 0.92–0.97 0.94*** 0.88–0.96
tic about the future
I’ve been feeling useful 3.93(1.05) 3.77(1.04) 4.17(0.80) 0.83*** 0.97*** 0.94–0.98 0.82*** 0.69–0.90
I’ve been feeling relaxed 3.53(1.08) 3.28(1.33) 3.78(1.06) 0.93*** 0.91*** 0.86–0.95 0.93*** 0.85–0.95
I’ve been feeling interest- 3.22(0.88) 3.14(0.85) 3.41(0.86) 0.95*** 0.90*** 0.85–0.94 0.95*** 0.90–0.97
ed in other people
I’ve had energy to spare 3.69(0.82) 3.66(0.95) 3.76(0.54) 0.86*** 0.95*** 0.91–0.97 0.85*** 0.74–0.92
I’ve been dealing with 3.97(0.87) 4.02(0.98) 3.85(0.73) 0.93*** 0.99*** 0.99–0.99 0.93*** 0.88–0.96
problems well
I’ve been thinking clearly 3.96(0.81) 3.81(1.03) 4.07(0.61) 0.90*** 0.94*** 0.90–0.96 0.90*** 0.82–0.95
I’ve been feeling good 4.11(0.82) 4.13(0.87) 3.95(0.77) 0.72*** 0.95*** 0.92–0.97 0.72*** 0.52–0.84
about myself
I’ve been feeling close to 3.69(0.83) 3.77(0.92) 3.51(0.60) 0.86*** 0.96*** 0.94–0.98 0.86*** 0.75–0.92
other people
I’ve been feeling confident 3.93(1.11) 3.80(1.12) 4.05(0.77) 0.81*** 0.81*** 0.72–0.88 0.82*** 0.66–0.89
I’ve been able to make 3.47(1.05) 3.21(1.21) 3.66(0.82) 0.92*** 0.97*** 0.95–0.98 0.91*** 0.84–0.95
up my own mind about
things
I’ve been feeling loved 3.49(1.05) 3.36(1.11) 3.68(0.88) 0.94*** 0.97*** 0.96–0.98 0.94*** 0.89–0.96
I’ve been interested in 3.47(1.00) 3.32(1.15) 3.66(0.69) 0.83*** 0.98*** 0.97–0.99 0.82*** 0.69–0.90
new things
I’ve been feeling cheerful 3.66(1.10) 3.61(1.20) 3.73(0.89) 0.92*** 0.98*** 0.97–0.99 0.92*** 0.86–0.96
Total score 51.88(9.73) 50.48(10.82) 53.07(6.49) 0.97*** 0.99*** 0.98–0.99 0.97*** 0.94–0.98
***P < 0.001.

510 Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021

 Original Article

TABLE 2.

Psychometric Properties of Spiritual Well-being Scale

Item First As- Second As- Second Assess- Pearson Intraclass 95% Intraclass 95%
sessment sessment ment Correlation Correlation Confidence Correlation Confidence
(Hindi (Hindi Ver- (English Version) Coefficient Coefficient Intervals Coefficient Intervals
Version) sion) n = 41 for Hindi– Hindi–Hin- for Hindi–
n = 102 n = 61 Mean English di Versions English
Mean Mean (SD) Versions n = 61 Versions
(SD) (SD) n = 41 n = 41
I don’t find much satisfaction 4.19(1.31) 4.14(1.19) 4.17(1.33) 0.97*** 0.95*** 0.92–0.97 0.96*** 0.93–0.98
in private prayer with God.
I don’t know who I am, where 4.26(1.19) 4.36(1.08) 3.87(1.24) 0.82*** 0.98*** 0.96–0.99 0.82*** 0.69–0.90
I came from, or where I’m
going.
I believe that God loves me 4.28(1.44) 4.31(1.42) 4.21(1.44) 0.98*** 0.96*** 0.94–0.98 0.97*** 0.96–0.99
and cares about me.
I feel that life is a positive 4.33(1.45) 4.13(1.43) 4.51(1.38) 0.95*** 0.99*** 0.98–0.99 0.95*** 0.90–0.97
experience.
I believe that God is imper- 3.84(1.45) 3.96(1.35) 3.48(1.50) 0.93*** 0.96*** 0.94–0.98 0.93*** 0.88–0.96
sonal and not interested in my
daily situations.
I feel unsettled about my 4.07(1.31) 4.22(1.25) 3.82(1.39) 0.97*** 0.92*** 0.87–0.95 0.97*** 0.94–0.98
future.
I have a personally meaning- 4.20(1.38) 4.18(1.36) 4.34(1.33) 0.96*** 0.97*** 0.94–0.98 0.96*** 0.92–0.98
ful relationship with God.
I feel very fulfilled and satis- 4.52(1.28) 4.41(1.30) 4.70(1.14) 0.95*** 0.98*** 0.96–0.99 0.95*** 0.92–0.97
fied with life.
I don’t get much personal 4.12(1.36) 4.31(1.29) 3.78(1.38) 0.99*** 0.98*** 0.96–0.99 0.98*** 0.97–0.99
strength and support from
my God
I feel a sense of well-being 4.50(1.30) 4.36(1.43) 4.78(0.96) 0.88*** 0.97*** 0.94–0.98 0.87*** 0.78–0.93
about the direction my life is
headed in.
I believe that God is con- 4.48(1.29) 4.45(1.25) 4.43(1.37) 0.98*** 0.98*** 0.96–0.99 0.98*** 0.97–0.99
cerned about my problems.
I don’t enjoy much about life. 4.10(1.34) 4.08(1.18) 4.04(1.49) 0.96*** 0.98*** 0.96–0.99 0.96*** 0.92–0.98
I don’t have a personally sat- 4.02(1.39) 4.29(1.10) 3.58(1.58) 0.96*** 0.95*** 0.91–0.97 0.96*** 0.93–0.98
isfying relationship with God.
I feel good about my future. 4.34(1.42) 4.21(1.47) 4.53(1.34) 0.97*** 0.99*** 0.99–0.99 0.97*** 0.95–0.98
My relationship with God 4.25(1.40) 4.24(1.55) 4.24(1.19) 0.96*** 0.99*** 0.98–0.99 0.96*** 0.93–0.98
helps me not to feel lonely.
I feel that life is full of conflict 3.02(1.51) 2.86(1.41) 3.24(1.56) 0.97*** 0.98*** 0.97–0.99 0.96*** 0.94–0.98
and unhappiness.
I feel most fulfilled when I’m 4.03(1.53) 3.93(1.54) 4.19(1.34) 0.95*** 0.98*** 0.96–0.99 0.94*** 0.90–0.97
in close communion with God.
Life doesn’t have much 4.32(1.43) 4.03(1.36) 4.56(1.46) 0.98*** 0.91*** 0.85–0.94 0.98*** 0.97–0.99
meaning.
My relation with God 3.95(1.44) 3.80(1.51) 4.26(1.18) 0.93*** 0.99*** 0.99–0.99 0.93*** 0.87–0.96
contributes to my sense of
well-being.
I believe there is some real 3.94(1.51) 3.62(1.61) 4.41(1.48) 0.98*** 0.94*** 0.90–0.96 0.98*** 0.97–0.99
purpose for my life.
Religious well-being 32.98(6.90) 41.65(7.93) 40.73(7.47) 0.98*** 0.99*** 0.98–0.99 0.98*** 0.96–0.99
Existential well-being 33.13(7.16) 40.31(6.70) 42.51(7.11) 0.98*** 0.98*** 0.97–0.99 0.98*** 0.96–0.99
Total score 66.11(12.62) 81.96(13.37) 83.24(13.10) 0.99*** 0.99*** 0.992–0.99 0.99*** 0.97–0.99
***P < 0.001. The Spiritual Well-being Scale is copyrighted, and the copyright of the original English scale and the translated Hindi scale belong to the original author of the
scale. For using this scale, please obtain permission from the original author.

Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021 511

 Grover and Dua

Hindi–Hindi version and cross-language for the powerful others in health beliefs of MHLC were more than 0.94, suggest-
agreement between Hindi–English ver- (0.393; P < 0.001). ing good to excellent test–retest reliabil-
sions were assessed by using the intra- The split-half reliability for WEMWBS, ity. For each item of various scales, the
class correlation coefficient (ICC) and as assessed by the Spearman–Brown coef- test-retest reliability was also very high.
Pearson’s correlation coefficient. ficient and Guttmann split-half value, Internal consistency of the various
was high (0.82). The split-half reliability scales, as assessed by Cronbach’s alpha,
Results for MHLC and SWBS total scores were was ≥0.8 for the total scores, and hence,
The study sample comprised 102 partic- 0.63 for both the scales (Table 4). Howev- excellent. However, when the internal
ipants, with a mean age of 33 (SD: 8.49) er, the same was lower for the subscales. consistency was evaluated for various
years and mean duration of education subscales of the scales, it was seen
of 15.1 (SD: 2.72) years. There was nearly
Correlation between that the Cronbach’s alpha was 0.651 (P
equal representation of males (51%) and WEMWBS, MHLC, SWBS, < 0.001) for the RWBS and 0.697 (P <
0.001) for the EWBS, which are in the
females (49%). The majority of the par- and CRS acceptable range. For the MHLC scale,
ticipants were married (61.8%), from nu-
clear families (56.9%), and urban locality A higher level of religiosity as assessed the Cronbach’s alpha for the internal
(92.2%). In terms of religion, 55.9% were by CRS was associated with significantly control domain was 0.845, suggestive
Hindus, 37.3% were Sikhs, and small pro- better well-being as assessed by WEM- of good internal consistency, whereas
portions were following Islam (3.9%) and WBS, RWBS, total score of SWBS scale, for the chance factor domain, it was
Christianity (2.9%). and lower chance health locus of control. very close to 0.7, indicative of an ac-
WEMWBS also had a significant positive ceptable level of internal consistency.
Psychometric Properties correlation with the SWBS and internal However, for the domain of powerful
Concurrence Between Hindi and locus of control, and negative correlation others, the internal consistency was
English Versions with chance health locus of control. Both 0.39, which can be considered as an un-
the subscales of SWBS had a significant acceptable level. The split-half reliabili-
As shown in Table 1, all the items of
correlation with each other (Table 5). ty of all the full scales was also in good
WEMWBS, the Pearson correlation coef-
to excellent range.
ficient for various items was ≥ 0.71 for Discussion All these findings suggest that the
the Hindi–English version, and all the
This study attempted to translate and Hindi translation of WEMWBS, SWBS,
associations were statistically significant
validate the Hindi versions of scales for and MHLC have an adequate level of
(Table 2). Similarly, there was significant
assessment of well-being and locus of psychometric properties in terms of in-
cross-language equivalence for each item
control in a group of people not known ternal consistency, test–retest reliability,
of SWS and MHLC (Tables 2 and 3).
to be diagnosed with any mental illness. and cross-language concurrence with the
Test–Retest Reliability Additionally, an effort was made to eval- English version of the scale. It is hoped
In terms of test–retest reliability for the uate the association of well-being and that the availability of these validated
total score for the Hindi version, ICC val- locus of control with the level of religi- scales will facilitate further research in
ue for WEMWBS was 0.995 (P < 0.001), osity. We chose to validate these three this direction.
SWBS was 0.946 (P < 0.001) and that for scales together because two of these eval- Additionally, this study also aimed to
three domains of MHLC were 0.969– uate different aspects of well-being, and evaluate the association of WEMWBS,
0.984 (P < 0.001). Similar ICC values the third scale, that is, MHLC, evaluates SWBS, and MHLC with the level of re-
were also noted for the individual items the locus of control, which can influence ligiosity, assessed by using CRS. It was
of the scales (Tables 1–3). the persons’ attitude towards health, ill- hypothesized that those with high reli-
ness, well-being, and help-seeking. giosity would have high SWB and high
Internal Consistency and Split-Half
We found that the Hindi versions of spiritual well-being. In terms of MHLC,
Reliability
the WEMWBS, SWBS, and MHLC have it was hypothesized that those with
The internal consistency of the Hindi an adequate level of psychometric prop- higher religiosity would have a higher
version was assessed using Cronbach’s erties in terms of internal consistency, chance of health locus of control.
alpha. As evident from Table 4, the Cron- test–retest reliability, and cross-language In terms of correlations, this study
bach’s alpha for WEMWBS was 0.923 (P concurrence with the English version suggests that SWB, as well as spiritual
< 0.001), and that for the total SWBS of the scale. The high Pearson correla- well-being (both religious and existen-
scale was 0.832 (P < 0.001). For the two tion coefficient values and ICC between tial), have a positive correlation with the
subscales of SWBS, the Cronbach’s alpha various items of the Hindi and English level of religiosity. However, an inverse
was 0.651 (P < 0.001) for the RWS and versions of the scale provide evidence for correlation was observed between the
0.697 (P < 0.001) for EWS. For the MHLC, the cross-language equivalence of vari- level of religiosity and chance locus of
the Cronbach’s alpha for the internal ous items. control. This inverse correlation possibly
control domain was the highest (0.845, P In terms of test–retest reliability, the suggests that attribution of control to a
< 0.001), followed by that for chance fac- ICC values for WEMWBS, SWBS, and higher power is not considered the same
tor (0.692, P < 0.001), and the least was MHLC total score and various domains as that attributed to luck or chance.

512 Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021

 Original Article

TABLE 3.

Psychometric Properties of Multi-Dimensional Health Locus of Control Scale

Item First As- Second As- Second As- Pearson Intraclass 95% Intraclass 95%
sessment sessment sessment Correlation Correlation Confidence Correlation Confidence
(Hindi (Hindi (English Coefficient Coefficient Intervals Coefficient Intervals
Version) Version) Version) for Hin- Hindi–Hindi for Hindi–
n = 102 n = 61 n = 41 di-English Versions English
Mean Mean Mean Versions n = 61 Versions
(SD) (SD) (SD) n = 41 n = 41
If I get sick, it is my own behavior 4.39(1.32) 4.37(1.38) 4.46(1.26) 0.95*** 0.96*** 0.94–0.98 0.95*** 0.91–0.97
which determines how soon I get
well again.
No matter what I do, if I am going 3.19(1.68) 3.45(1.66) 2.75(1.49) 0.98*** 0.97*** 0.95–0.98 0.98*** 0.96–0.99
to get sick, I will get sick.
Having regular contact with my 4.00(1.58) 3.96(1.59) 4.07(1.61) 0.98*** 0.99*** 0.98–0.99 0.98*** 0.96–0.99
physician is the best way for me
to avoid illness.
Most things that affect my health 3.32(1.66) 3.62(1.65) 2.95(1.51) 0.94*** 0.98*** 0.96–0.99 0.94*** 0.89–0.97
happen to me by accident.
Whenever I don’t feel well, I 3.65(1.76) 3.37(1.80) 4.04(1.54) 0.96*** 0.98*** 0.97–0.99 0.96*** 0.92–0.98
should consult a medically trained
professional.
I am in control of my health. 4.16(1.44) 4.16(1.26) 4.14(1.60) 0.92*** 0.96*** 0.94–0.98 0.92*** 0.86–0.96
My family has a lot to do with my 3.03(1.71) 3.27(1.69) 2.70(1.60) 0.99*** 0.96*** 0.94–0.98 0.99*** 0.98–0.99
becoming sick or staying healthy.
When I get sick, I am to blame. 3.79(1.40) 3.77(1.27) 3.75(1.52) 0.99*** 0.95*** 0.92–0.97 0.99*** 0.98–0.99
Luck plays a big part in determin- 3.28(1.68) 3.40(1.70) 3.26(1.48) 0.93*** 0.99*** 0.98–0.99 0.93*** 0.87–0.96
ing how soon I will recover from
an illness.
Health professionals control my 4.28(1.20) 4.13(1.20) 4.34(1.29) 0.98*** 0.97*** 0.94–0.98 0.98*** 0.96–0.99
health.
My good health is largely a matter 3.26(1.43) 3.45(1.36) 3.00(1.62) 0.97*** 0.96*** 0.94–0.98 0.97*** 0.94–0.98
of good fortune.
The main thing which affects my 4.65(1.30) 4.81(1.04) 4.21(1.49) 0.97*** 0.96*** 0.93–0.98 0.97*** 0.94–0.98
health is what I myself do.
If I take care of myself, I can avoid 4.87(1.23) 4.85(1.13) 4.65(1.54) 0.91*** 0.95*** 0.92–0.97 0.91*** 0.84–0.95
illness.
Whenever I recover from an 4.29(1.38) 4.62(1.18) 3.78(1.45) 0.89*** 0.97*** 0.96–0.98 0.89*** 0.79–0.94
illness, it’s usually because other
people (for example, doctors,
nurses, family, friends) have been
taking good care of me.
No matter what I do, I ‘m likely to 3.27(1.61) 3.24(1.65) 3.31(1.55) 0.95*** 0.97*** 0.94–0.98 0.95*** 0.90–0.97
get sick.
If it’s meant to be, I will stay 3.28(1.62) 3.49(1.68) 3.04(1.49) 0.98*** 0.99*** 0.98–0.99 0.98*** 0.97–0.99
healthy.
If I take the right actions, I can 4.66(1.26) 4.72(1.14) 4.58(1.43) 0.99*** 0.97*** 0.95–0.98 0.99*** 0.99–0.99
stay healthy.
Regarding my health, I can only 4.39(1.37) 4.59(1.26) 4.04(1.51) 0.95*** 0.99*** 0.98–0.99 0.95*** 0.91–0.97
do what my doctor tells me to do.
Internal health locus of control 26.54(5.99) 26.70(4.79) 25.82(7.11) 0.91*** 0.98*** 0.97–0.99 0.99*** 0.98–0.99
Powerful others health locus of 23.67(4.53) 23.96(3.57) 23.00(5.09) 0.98*** 0.97*** 0.95–0.98 0.98*** 0.96–0.98
control
Chance health locus of control 9.80(3.96) 10.49(3.79) 8.97(3.37) 0.98*** 0.98*** 0.97–0.99 0.97*** 0.95–0.98
***P < 0.001.

Indian Journal of Psychological Medicine | Volume 43 | Issue 6 | November 2021 513

 Grover and Dua

TABLE 4.

Internal Consistency and Split Half Reliability of the Scales

Cronbach’s Alpha for the Cronbach’s Alpha Spearman Brown Guttmann Split Half
Scale/Domains Coefficient
Part 1 Part 2
WEMWBS
Total WEMWBS 0.92*** 0.88*** 0.88*** 0.82*** 0.82***
SWBS
Total SWBS 0.83 *** 0.62*** 0. 85*** 0.63*** 0. 60***
Religious 0.65*** 0.22*** 0.75*** 0.48*** 0.46***
Existential 0.69*** 0.43** 0.72*** 0.54*** 0.518***
MHLC
Total 0.77*** 0.62*** 0.75*** 0.63*** 0.63***
IHLC 0.84*** 0.66*** 0.92*** 0.73*** 0.73**
PHLC 0.39*** 0.08*** 0.73*** 0.12*** 0.12***
CHLC 0.69*** 0.95*** 1.00*** 0.33*** 0.28***
***P < 0.001. WEMWBS: Warwick Edinburg Mental Well-being Scale, SWBS: Spiritual Well-being Scale, MHLC: Multi-dimensional Health Locus of Control Scale.

TABLE 5.

Correlations of Different Scales and with Centrality Religiosity Scale

CRS WEMWBS RWBS EWBS Total SWBS Internal Health Powerful
Locus of Control Others
Health Locus
of Control
WEMWBS total 0.22 X X X X X X
score (0.03)*
RWBS 0.49 0.53 X X X X X
(<0.001) *** (<0.001)***
EWBS 0.14(0.14) 0.31 0.57 X X X X
(0.001) ** (<0.001)***
Total SWBS 0.35 0.41 0.87 0.89 X X X
(<0.001)*** (<0.001)*** (<0.001)*** (<0.001)***
Internal health locus 0.16(0.11) 0.44 –0.41 0.31 0.40 X X
of control (<0.001)*** (<0.001)***) (0.001)** (<0.001)***
Powerful others –0.05 0.08 –0.11 0.09 0.11(0.27) 0.73 X
health locus of (0.57) (0.43) (0.290 (0.36) (<0.001)***
control
Chance health locus –0.27 –0.28 –0.49 –0.43 0.52 –0.24 0.05
of control (0.006)** (0.005)** (<0.001)*** (<0.001)*** (<0.001)*** (0.013)* (0.62)
* P < 0.05, ** P < 0.01, ***P < 0.001. WEMWBS: Warwick Edinburg Mental Well-being Scale, SWBS: Spiritual Well-being Scale, RWBS: Religious Well-being Scale, EWBS:
Existential Well-being Scale, MHLC: Multi-dimensional Health Locus of Control Scale, CRS: Centrality of Religiosity Scale.

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