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 Table of Contents  
Year : 2022  |  Volume : 9  |  Issue : 2  |  Page : 58-67

Uskudar life meaning and goals scale validity and reliability studies

1 Department of Psychiatry, Uskudar University, NPIstanbul Neuropsychiatry Hospital, Istanbul, Turkey
2 Department of New Media and Journalism, Faculty of Communication, Uskudar University, Istanbul, Turkey

Date of Submission10-Feb-2022
Date of Acceptance18-Jul-2022
Date of Web Publication29-Aug-2022

Correspondence Address:
Aylin Tutgun Ünal
Department of New Media and Journalism, Faculty of Communication, Uskudar University, Uskudar, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jnbs.jnbs_4_22

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Aim: One of the important factors that cause stress today is aimlessness. Determining the meaning and purposes of life has an impact on both the mental and physical health of the individual. Two types of values are mentioned as tool values and purpose values. Measuring the life goals to include these values is seen as important for determining the life goal skills of individuals. Hence, it is aimed to measure meaning and purpose and to measure perceptions about it. Materials and Methods: This study aimed to carry out validity and reliability studies of the Uskudar Life Meaning and Goals Scale (USLIFE). The sample consisted of 1026 people from Turkey. Factor analysis revealed that the scale consists of seven factors. Results: The first factor “Abstract Meaning Skill” explains 14.59% of the variance, the second factor “Skill to Delay of Gratification” 10.31% of the variance, the third factor “Concrete Meaning Skill” 8.97% of the variance, the fourth factor “Internal Control Skill” 5.53% of the variance, the fifth factor “Medium- and Long-Term Planning Skill” 4.60% of the variance, the sixth factor “Belief in Death” 4.39% of the variance, and the seventh factor “Ego Ideal Perception” explains 3.87% of the variance. The seven-factor structure consisting of 28 items in total explained 52.28%. In addition, seven factors confirmed the USLIFE in the confirmatory factor analysis. Goodness-of-fit values were found to be acceptable. The Cronbach's alpha value of the scale was found to be 0.74. Conclusion: A valid and reliable scale, named “USLIFE,” has emerged. This scale measures people's life goals skills and is graded in the five-point Likert type between “completely agree” and “never agree.”

Keywords: Life goals, life skills, scale, validity and reliability

How to cite this article:
Tarhan N, Ünal AT. Uskudar life meaning and goals scale validity and reliability studies. J Neurobehav Sci 2022;9:58-67

How to cite this URL:
Tarhan N, Ünal AT. Uskudar life meaning and goals scale validity and reliability studies. J Neurobehav Sci [serial online] 2022 [cited 2023 Mar 23];9:58-67. Available from: http://www.jnbsjournal.com/text.asp?2022/9/2/58/355255

  Introduction Top

One of the important factors that cause stress today is aimlessness. Determining the purposes of life has an impact on both the mental and physical health of the individual. It is important to create goals worth living for in psychology. Values that bind people to life, and values are the course of life goals.

Values guide our behavior and we try to understand others in line with values. Values are common concepts accepted by society as a whole.[1] It is also expressed as a cognitive representation of needs.[2],[3] Although their behavior can be directed, it guides how people behave as high-level structures that do not depend on the situations that exist at the time.[4],[5] In this context, if the person has adopted a value that contradicts himself, he does not conform to himself and may experience conflict. Thus, in order for the values to bring happiness, the person is expected to adopt values that are compatible with the person and the society in which he lives, which eliminates conflict or incompatibility within himself.[6]

Moral reasoning has an important place in one's decision-making. This type of reasoning includes three degrees. The most basic is that the person determines their decisions by considering the recent results. In this type of decision-making, the individual aims to save the existing day by considering his comfort at the moment. Average Moral reasoning includes social order, responsibility, and abstract thinking. The third species is based on more advanced thinking and aims to be altruistic, fair, and not to harm others.

Today, many researches are carried out on the value system of young individuals focusing on academic success.[7],[8],[9],[10],[11] In these researches, business life, perspectives on life, tolerance to differences, marriage, and family life perspectives are examined and it is discussed whether values are fully formed in young people.[12],[13] However, studies have been found that emphasize that the value system has evolved into the online value system with the effects of social media.[14],[15]

When the field article is examined, intelligence quotient (IQ) is considered important for scientific gain, emotional quotient (EQ) is considered important for life gain, and it is stated that EQ is learnable.[16] As a science aimed at gaining life, positive psychology operates based on people's own will, purposes, and values in the society in which they live and supports the EQ of people with a high IQ.[17] Thus, individuals with individual consciousness with EQ, which translates values into gains, can make sense of the society they live in from a spiritual point of view, regardless of the brain–mind spiral.

On the other hand, if anomie (normlessness) occurs in a society, social conflicts occur. This is due to the need for each individual to continue their life depending on the society. This demonstrates that values are vital and need to be supported with EQ.[18],[19] Accordingly, EQ affects life goals and psychological well-being along with values.

Although the fact that individuals who are committed to the purpose they think that they can achieve their goal and they want it indicates a saturated life, it is not a guarantee of purely psychological well-being.[20],[21],[22] In one study, it was investigated which types of life goals lead to increased or decreased individual well-being, and the objectives are divided internally and externally. Accordingly, the purposes such as contribution to society, individual development, interpersonal communication, and physical well-being are “internal;” popularity, influence, and wealth are “external” purposes. In the research, it was found that internal objectives have a high level of self-esteem and self-realization from the parameters of individual well-being and positive, negative relationship with depression and anxiety. When the effect of external purposes on individual well-being was examined, a negative relationship emerged.[23] Subsequent research supported these results.

However, psychometric scales are also needed to measure the existing situation in determining values and life goals. When the measurement tools are examined, it is noted that the number of scales that can measure the life goals that take into account the cultural values of our country is descendent. When the field is examined, the Life Goals Scale (LGS) developed by Ilhan in 2009 is found. The scale of seven-point Likert consisting of 47 items consists of two upper factors and has nine sublevels; the internal coefficients of consistency of LGS are in the range of 0.74–0.90 for subdivisions and, when looking at the upper dimensions, are set at 0.85 for the inner and 0.77 for the external.[24]

On the other hand, there is a “LGS” in Scales of Psychological Well-Being, which was developed by Ryff in 1989 and adaptation to Turkish by Akin in 2008, consisting of a combination of six scales.[25],[26] For the scale of six-point Likert, which has 14 expressions of each dimension and consists of 84 items, the reliability of the subscale of life purpose, i.e., the coefficient of internal consistency, was found to be 0.90. A study by scale found that as adolescents' self-esteem levels rise, their life purpose and positive relationships with others increase.[27]

Another scale, “Adolescent Form of Determining Life Goals in the Context of Positive Psychotherapy (PPYABÖ),” was developed by Eryilmaz in 2010 in the context of positive psychotherapy and on high school students.[28] The measuring tool is used to determine the life goals of adolescents in different departments and is rated as type of four-point Likert. The scale consists of three dimensions: success (career) objectives, relationship objectives and body (sensation) objectives, and Cronbach's alpha value of all sizes ranges from 0.68 to 0.85. In later years, the scale was also valid and reliable for university students by the researcher.[29]

In addition, the “LGS” developed by Aydiner in 2011, consisting of 31 items and 5 dimensions, is found in the literature.[30] Validity and reliability studies are shown to be “Personal Development,” “Funds Gain,” “Physical Appearance,” “Social Responsibility,” and “Individual Awareness.” LGS five-point Likert (none, some, partly, much, and very much) types and contains plain expressions.

Tarhan (2015) refers to two types of values as tool values and purpose values, and therefore, the necessity of establishing measuring instruments to cover this context has arisen. Objective values indicate more abstract objectives in a person's life. Tool values are a way to achieve their goals in the life of the person. Although the objective values can be classified in themselves, they have virtues such as love, trust, being compassionate, enjoying doing goodness, having social boundaries, being honest and fair, being tolerant and peaceful, and sharing. Tool values are values that eliminate negative emotions such as being organized, congratulating success, saying nice words, showing relaxing, and relaxing qualities that are appropriate by others, trying to do the job, being canny, being soft and flexible in the face of situations, being polite to people, and making appropriate comments that are not considered wrong. On the other hand, considering that values are universally and culturally divided, it is clear that the values of this means and purpose will vary from culture to culture and even from nation to world. From this point on, measuring the life objectives to include these values is seen as important for determining the life goals skills of individuals.

When the field of young generations in our country and abroad is examined, research on generations and values abroad does not reflect our country. Accordingly, it is stated that differences are arising from socioeconomic and cultural conditions in our country and even these differences are observed from school to school.[31] In fact, a study has found that people born in 1981 and beyond in our country have different expectations in terms of their career prospects than people in other countries.[32]

For this reason, it is seen that the scales of life objectives with limited dimensions are developed or adapted with scales aimed at measuring values in different fields such as work life, school life, and family life in our country to understand individuals at the micro-level.[33],[34]

With this research, it is aimed to develop the multidimensional Uskudar Life Meaning and Goals Scale (USLIFE), which covers the objectives and tool values in question and is aimed at determining the life goals of the person.

  Materials and Methods Top

The ethics committee approval has been obtained from the Uskudar University Noninterventional Research Ethics Committee (61351342/April2021-27).

USLIFE was built up from people aged 15 and over for validity and reliability studies. In this context, the sample of the study was established from 1026 people over the age of 15 reached through the Internet throughout Turkey. Since scale development studies will be carried out, various opinions indicated in the field have been examined for the suitability of the data set for factor analysis. Accordingly, there is an opinion that the sample size can be between 100 and 250. Or it may be at least five to ten times the number of items in the scale.[35],[36]

Considering that the scale consists of 28 items in the study, the number of 1026 samples is quite sufficient. In addition, 68.3% of the 1026 participants were women and 31.7% were men. When the age distributions are examined, the youngest of the participants is 15, the eldest is 71, and the average age is 33.

Measurement instruments

Uskudar Benevolance and Malevolance Scale

The Uskudar Benevolance and Malevolance Scale (USBEMA) consists of 35 items and 2 factors, developed by Tarhan and Tutgun-Ünal.[37] The first factor “Purpose Oriented” explains 35.2% of the variance and the second factor “Process Oriented” 7.9% of the variance and 35 items in Total scale explains 50.6% of the variance. In addition, two factors confirmed the USBEMA in the confirmatory factor analysis (CFA) (Chi-square/degrees of freedom: 3.38; RMSEA: 0.06; NFI:0.93; NNFI: 0.93; CFI: 0.96; GFI: 0.93; AGFI: 0.86). The internal consistency coefficient (α) of the scale was found to be 0.92. It has been developed to measure benevolence and malice toward purpose and process, and it is to measure honesty, keeping one's word, accountability, taking shelter in a transcendent power, empathy, being able to love and benevolently, patience and suffering, virtuousness, and concern for fair and equitable sharing. In the criteria validity study of USLIFE developed in this study, it was used considering that it may be associated with USLIFE.

Uskudar Life Meaning and Goals Scale

For the USLIFE validity and reliability studies, expert opinions were first obtained by generating a pool of items, and then, the content validity of the scale, structure validity with factor analysis, the discriminant validity analysis, and internal consistency reliability were made.

As a result of the examination of the article field of the material pool of the scale, it was built with the headings “Tangible Semantic Skills,” “Belief in Death,” “Skill to Delay of Gratification,” “Abstract Semantic Skill,” “Internal Control Skill,” “Medium- and Long-Term Planning Skills,” and “Perception of Ego Ideal” and items were produced within the scope of the objectives and tool values related to the subject under these headings. Thus, an expert opinion inventory of the scale consisting of 28 items was built and presented to the opinions of six experts. To evaluate the candidate items in the expert opinion inventory, the options “Item is appropriate to remain on the scale,” “Item may remain on the scale but is unnecessary,” and “Item is not appropriate to remain on the scale” are included. To include interdisciplinary opinion, the expert pool was composed of two academicians from each of the fields of psychology and psychiatry and two experts from communication sciences, and the inventories were sent to the experts via E-mail. Subsequently, with the help of the formula proposed by Miles and Huberman, the compliance rates of the items were calculated.[38]

Compliance rates are calculated using the ratings in the inventory for each item. Accordingly, it was noted that the relevant article did not descend below 0.80 by scoring between 0 and 1. In addition, in line with the opinions of the experts, the articles were reviewed and arranged in terms of spelling and grammar.

The 28-item candidate scale was rated from the lower level of “I do not agree at all” to the “I agree at all” level in the type of Likert without the article being eliminated after expert opinions and distributed to the participants via an online survey according to the principle of voluntariness in March 2021. After the data collection phase, the Explanatory Factor analysis (EFA) phase was started.

EFA is often applied as one of the statistical calculation techniques performed following a large number of variables within the scope of the structural validity of scale development. Bartlett test and Kaiser–Meyer–Olkin (KMO) test specified in the literature were applied to determine whether the data collected before EFA were made met the conditions of factor analysis. KMO is rated as “excellent” to be 0.90 or above, “very good” to be in the range of 0.80–0.89, “good” to be in the range of 0.70–0.79, “medium” in the range of 0.60–0.69, “weak” in the range of 0.50–0.59, and less as “unacceptable.”[39] In addition, the value of Bartlett sphericity is expected to make sense.

With EFA, which is made during the construction validity phase of the scales, the factor, in other words, the number of dimensions can be determined and self-worth statistics (eigenvalue) are used for this purpose. According to self-worth statistics, factors whose value is usually equal to or higher than 1 are taken into account.[40] If it is desired to create a distinction based on the subject, the researcher can determine the number of factors manually by empirical. It is ideal when the variance rate revealed by the factor analysis varies between 40% and 60% in social sciences. On the other hand, correlation values are looked at in the relationship of factors with each other and total in the building validity studies of the scale. When interpreting correlation values, while the range of 0.30–0.70 is “medium,” it is stated that it indicates a “high” relationship above 0.70 and a “weak” relationship below 0.30.[41]

Differentiation validity studies are carried out to determine whether the items on the scales of the property to be measured are suitable and the item differentiation index is calculated. Accordingly, the answers given to each question are sorted as points and 27% of the upper group and subgroup are taken and the difference between the two groups is looked at by independent group t-test. The results reinforce the validity of studies by giving an idea of the internal consistency of the scale. Cronbach's alpha coefficients were calculated by analyzing the internal consistency of the item according to the item variances during the reliability studies phase. As a result of the studies, the validity and reliability of the USLIFE were revealed.


Data collection was carried out from May 1 to 7, 2021, according to the principle of voluntariness through an online survey. The study group consisted of all individuals aged 15 and elder through randomly selected sampling. USBEMA and USLIFE were applied online to the participants. An average of 15 min to complete the applied survey was enough.

Data analysis

The USLIFE was divided into data sets for validity and reliability studies, and explanatory factor analysis (EFA), discrimination calculations, and reliability studies were carried out within the scope of structure validity on the 510-sample section. CFA was applied to the 516-sample section. In the discrimination validity studies, 27% of the upper group and subgroup were taken and the difference between the two groups was looked at by independent group t-test. The reliability coefficient of scales is determined by the value of Cronbach's alpha. SPSS 26.0 statistical program was used for all validity and reliability analyses. In addition, the AMOS program modeled for the interrelationship and compatibility of dimensions and calculated the value of goodness of fit (Chi-square/release value, RMSEA, NFI, NNFI, CFI, GFI, and AGFI).

  Results Top

Validity and reliability studies of the Uskudar Life Meaning and Goals Scale

In this part of the study, evaluations were made for the USLIFE. Content validity of the scale, structure validity, discrimination validity, CFA, and reliability studies are contained within.

Content validity

USLIFE item pool was created from 28 items in the first stage and presented to expert opinions. Items were examined by six experts accompanied by an expert opinion inventory to include interdisciplinary opinions. After that inter rater reliability were calculated. Accordingly, the study looked at a compliance rate of 0.80 and found it appropriate that all 28 items remained on a draft scale. Thus, EFA was performed on 510 people of the data obtained by applying the 28-point draft scale to 1026 participants.

Structure validity-explanatory factor analysis

While AFA was made to determine the factor formation of the USLIFE, KMO coefficient and Bartlett sphericity test were examined whether the collected data complied with the factor analysis requirements. Accordingly, the KMO coefficient value was found to be 77.7. Bartlett sphericity test result found significant (X2 = 3146,715, SD: 3.78, P = 0,000). Results showed the appropriateness of the data for factor analysis. In this direction, factor analysis was started with the 28-point draft scale obtained after expert opinions. After EFA was made, it was understood that it was in a seven-factor structure, since the self-worth (eigenvalue) was greater than 1 for the USLIFE. Accordingly, the highest 0.86 and lowest 0.45 for 28 items' factor loads were found. The explained variance rate was found as 52,288, which was to be understood to be acceptable. The eigenvalue of the factors in the structure that occurs as seven factors and the variance ratio explained are given in [Table 1].
Table 1: Factor structure and explained variance rate

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As shown in [Table 1], the explanatory variance rate of the factor with equity of 4.08 is 14.59%. The variance rate of the second factor with an eigenvalue of 2.88 - 10.31%, the variance rate of the third factor with equity of 2.51 is 8.97%, the variance rate of the fourth factor with an eigenvalue of 1.55 - 5.53%, the variance rate announced by the fifth factor with equity of 1.28 - 4.60%, the variance rate of the sixth factor with equity of 1.23 - 4.39%, and the variance rate of the seventh factor with equity of 1.08 is 3.87%. The total variance rate was found 52.28%.

Another method is the screen pilot test for consider to determine the number of factors. The number of factors is determined by the changes in the points of slopes. The line chart of USLIFE, which appears to be seven-dimensional, is located in [Figure 1].
Figure 1: Screen pilot of USLIFE. USLIFE: Uskudar Life Meaning and Goals Scale

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After determining the number of factors, item factor loads were examined, the factor load value of the items was checked according to the conformity of the lower segment point to 0.44, and the factor structure was released. Accordingly, the item factor loads of the scale in the seven-dimensional structure are given in [Table 2].
Table 2: Factor load values of Uskudar Life Meaning and Goals Scale items

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When the item factor load values were examined, the item load values of the seven-factor structure of the scale received appropriate values. Item factor load values were found to be highest 0.815 and lowest 0.447. In the next stage, the contents of the items are examined and the factors are given names.

Item sequences were taken into account when naming dimensions and the dimensions were reordered. Accordingly, the 11th, 19th, 20th, 22nd, 23rd, and 28th items have formed the first dimension and the items are evaluated in terms of content and the dimension is called “Abstract Meaning Skill.” The 8th, 9th, 10th, and 17th items formed the second dimension. When the contents of the items are examined, it is understood that it is related to the “Skill to Delay of Gratification.” The 1st, 2nd, 4th, and 26th items constitute the third dimension and are called “Tangible Semantic Skills.” The 12th, 13th, 14th, and 15th items constituted the fourth dimension. By examining the contents, the dimension is called “Internal Control Skill.” The 3th, 16th, 18th, and 27th items constituted the fifth dimension. Dimension is called “Medium- and Long-Term Planning Skills.” The 5th, 6th, and 7th items constituted the sixth dimension, and when their contents were examined, it was found to be related to the “Belief in Death.” Items 21, 24, and 25 constitute the seventh dimension. By examining the contents of the items, the dimension is called “Ego Ideal Perception.”

On the other hand, in addition to building the items with positive expressions, some items should be recoded and evaluated in reverse code. Accordingly, it was found properly to evaluate the items of 1, 2, 5, 4, 5, 8, 9, 10, 12, 13, 14, 15, 17, 19, 20, 21, 23, 24, 25, 26, and 28 with reverse coding, and the items of 3, 6, 7, 11, 16, 18, 22, and 27 with direct coding on the scale. Respondents to the statements in the measurement tool will be scored by selecting the participation frequency statement rated from the “I do not agree at all” subfrequency level to the “agree at all” top frequency level (I do not agree at all: 1 point, totally agree: 5 points). In the next stage, the relationship of dimensions was examined and is shown in [Table 3]. When [Table 3] is examined, it is seen that a correlation test is performed to understand the relationship of dimensions with scale total. According to Pearson correlation coefficients, it was concluded that dimensions are moderately associated with the sum of scale (r > 0.30).
Table 3: Relationship of dimension to Uskudar Life Meaning and Goals Scale

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Discriminant validity

At this stage, item discriminant validity studies were carried out to determine whether the items on the scale measured the desired property. Data collected from 137 participants were sorted from large to small and difference tests were applied to data in the upper 27% and subgroups of 27%.

When [Table 4] is examined, the results were found to be significant, and it was concluded that the USLIFE was a scale that measured the desired characteristics [Annexure 1]. Accordingly, the top score from the USLIFE is 140 and the minimum score is 28. The average score with 1026 participants was 104.
Table 4: Uskudar Life Meaning and Goals Scale's discrimination validity

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Convergent validity

At this stage, the relationship between the USBEMA and USLIFE, which is thought to be related to the validity of the criteria, has been tested. As shown in [Table 5], a positively significant relationship was found.
Table 5: Convergent validity of Uskudar Life Meaning and Goals Scale

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Reliability studies

The Cronbach's alpha internal consistency coefficient of the scale was calculated in the scope of USLIFE's reliability studies and the Cronbach's alpha coefficient of the 28 items, which constitute USLIFE, was found to be 0.73. The resulting values showed an acceptable level of reliability of the scale. Thus, a valid and reliable “USLIFE” emerged. The internal consistency calculations of the USLIFE by dimensions and the scale total are in [Table 6].
Table 6: Uskudar Life Meaning and Goals Scale and the reliability of dimensions

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As shown in [Table 6], the total Cronbach's alpha value was found 0.74 in the USLIFE which showed an acceptable degree of reliability. When the subscales were examined, the Cronbach's alpha value was found to be the lowest 0.54 and highest 0.75. Thus, the values taken by the dimensions also demonstrated acceptable reliability.

Confirmatory factor analysis

The goodness-of-fit values were tested by performing CFA with data set of 516 people following internal consistency coefficient calculations of factors and USLIFE total within the scope of structure validity of USLIFE, the relationship of factors with scale, and discriminant validity and reliability studies.

The model resulting from CFA performed in the AMOS program is given in [Figure 2]. Accordingly, the dimensions revealed by EFA are statistically verified and the results are in [Table 7]. [Table 7] shows the goodness-of-fit index values of the USLIFE. Ki-square/release value according to the findings obtained in the validating factor analysis was found to be 3.38, RMSEA: 0.068, NFI: 0.93, NNFI: 0.93, CFI: 0.96, GFI: 0.93, and AGFI: 0.86. Thus, it is seen that these values meet the acceptable goodness-of-fit index values. It has been concluded that the USLIFE is verified by seven factors.
Figure 2: USLIFE's confirmatory factor analysis. USLIFE: Uskudar Life Meaning and Goals Scale

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Table 7: Uskudar Life Meaning and Goals Scale of goodness-of-fit index

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  Conclusion Top

The USLIFE is a measurement tool developed by researchers to measure individuals' life goals and meaning. Thus, in this study, it is aimed to measure whether there are goals that will add meaning to life and to measure perceptions about it. After validity and reliability studies, it was revealed that it consisted of 28 items and 7 factors, and the model built up from seven-factor structures was tested and verified with validating factor analysis.

The USLIFE is a five-point Likert scale, with the maximum score from the scale total being 140 and the minimum score being 28. Accordingly, the increase in the score taken from the USLIFE means that the individual's life-purpose skills increase.

To interpret the scores obtained from the USLIFE, the highest score and lowest score ranges that can be taken from the scale are determined and the range coefficients are calculated according to the five-point Likert scale. The total score taken from the scale is evaluated in terms of a person's life skills as “low level” in the range of 28–65 points, “intermediate level” in the 66–102-point range, and “high level” in the range of 103–140 points. The USLIFE has explained 52.28% of the total variance, which is considered acceptable for social sciences. Cronbach's alpha coefficient of internal consistency in reliability studies was found to be 0.74. Dimensions also provided internal consistency in themselves, and it turned out that USLIFE is a valid and reliable measuring tool. As a result of the CFA studies, the goodness-of-fit values of the scale were found to be at an acceptable level. Thus, it is thought that the USLIFE will provide detailed data with the seven-dimensional structure in which people involve in measuring life objectives. These dimensions are Tangible Semantic Skills, Belief in Death, Skill to Delay of Gratification, Intangible Semantic Skills, Internal Control Skills, Medium- and Long-Term Planning Skills, and Perception of Ego Ideal which are included in the scale and differ in this aspect from existing scales.

Although it is assumed that determining life goals shows a similar quality in the context of positive psychotherapy, the seven-dimensional structure of the USLIFE indicates that comprehensive results can be achieved when new dimensions are added. Thus, updating existing scales with new dimensions is seen as important for responding to new needs. It is thought that the USLIFE developed in the Turkish sample can be used in examinations with different variables in people aged 15 and over and will contribute to the literature with its multidimensional structure.

Patient informed consent

There is no need for patient informed consent.

Ethics committee approval

The ethics committee approval has been obtained from the Uskudar University Noninterventional Research Ethics Committee (61351342/April2021-27).

Conflicts of interest

There are no conflicts of interest to declare.

Financial support and sponsorship

No funding was received.

Author contribution subject and rate

  • Aylin Tutgun Ünal (%50): Design the research, data analysis and wrote the whole manuscript.
  • Nevzat Tarhan (%50): Contributed with scale items, theoretical background and data collect.

  References Top

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  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]


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