Beliefs about surgery: Development and validation of an instrument to assess cognitive representations about surgery,in the context of a chronic illness

Objectives: Within a trial of medical and surgical treatments for gastro-esophageal reflux disease (GORD), involving randomised arms and preference arms, we tested the applicability of the Beliefs about Medicines Questionnaire (BMQ) and developed and tested the validity of a new Beliefs about Surgery Questionnaire (BSQ). Methods: Patients with GORD (N = 43) were interviewed to elicit their beliefs about medical and surgical treatments. These contributed to the development of BSQ items. The BMQ and BSQ were completed by trial participants at baseline (randomised trial: N = 325; preference trial: N = 414). Factor analysis and discriminant function analysis were used to assess validity. Results: Principal components analysis (PCA) largely replicated the four-factor BMQ structure. PCA of the combined BMQ/BSQ yielded six factors explaining 54.5% variance. BSQ items loaded onto distinct factors, demonstrating divergence from BMQ. As predicted, BMQ/BSQ scores enabled correct classification of 78.5% of participants to medication and surgery groups in the preference trial (χ²(6) = 205.9, p < 0.001) but only 54.5% (no better than chance) in the randomised trial (χ²(6) = 9.4, p = 0.154). Conclusions: The BSQ is a valid measure of perceptions about surgical treatments for GORD. With the BMQ, it provides information that may guide patients’ choices about treatment. This measure may be applicable to other conditions.     

The Illness Perceptions and Treatment Beliefs of Individuals with Severe Haemophilia and their Role in Adherence to Home Treatment

The majority of individuals in the UK with severe haemophilia treat themselves at home with clotting factor. The aim of this study was to examine patient's beliefs about their haemophilia, their beliefs regarding treatment with clotting factor and to assess whether relationships existed between these factors and adherence to home treatment. Patient beliefs were assessed by posting individuals with severe haemophilia A and B ( n = 104) the Illness Perceptions Questionnaire (IPQ) and the Beliefs about Medicines Questionnaire (BMQ). The final analysis was based on 65 questionnaires yielding a response rate of 63%. Adherence to the frequency and to the amount of each clotting factor dose was assessed for individuals treating prophylactically and the amount of each clotting factor dose for those only treating 'on-demand'. Adherence scores were calculated by comparing individual patient treatment records with recommended regimens. Regression analysis indicated that perceptions of illness identity and treatment necessity explained a significant amount of the variance in adherence to frequency of prophylactic infusions and that illness identity was associated with the adherence to the amount of each prophylactic dose. Further regression analysis also showed that the amount of each dose of clotting factor administered on-demand was associated with perceptions regarding the necessity of treatment. Analysis with a combined measure of adherence to dose amount indicated that patients treating on-demand or with prophylaxis who under treated, recorded significantly lower perceptions of illness consequence than individuals who were fully adherent or who over-treated. The results suggest that assessing illness perceptions, especially beliefs regarding identity , consequence and necessity of treatment, may play a valuable role in identifying which individuals are least likely to adhere to treatment.     

The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV

Objective: The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV.

Design: A total of 458 HIV positive African-Americans completed a cross-sectional survey.

Main Outcome Measures: Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs.

Results: All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = ?.339 to ?.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence.

Conclusion: Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.     

Attitudes toward psychotropic medications

Attitudes and beliefs towards psychotropic medication were evaluated among psychiatric outpatients, patients receiving buprenorphine treatment for substance abuse, and a group who reported never having used psychotropic medications (non-users). The Drug Attitude Inventory scale and the Beliefs about Medicines Questionnaire General were used to assess attitudes and beliefs of 49 participants. Non-users exhibited more negative attitudes and beliefs toward psychotropic medication than both psychiatric groups.     

Questionnaire de sensibilité au rejet : qualités psychométriques de la traduction française de l’Adult Rejection Sensitivity Questionnaire (ARSQ)

IntroductionExacerbated rejection sensitivity is a psychological process strongly present in certain personality disorders. Berenson et al. (2013) developed the Adult Rejection Sensitivity Questionnaire (A-RSQ), which evaluates the anxious expectation of perceived rejection by people close to them.ObjectiveThe purpose of our study was to investigate the psychometric qualities of a French version of the A-RSQ.MethodThis study was conducted with 140 French participants. The participants completed online our French translation of the A-RSQ and the Borderline Symptoms List (BSL-23), the Experiences in Close Relationships-Revised Questionnaire (ECR-R) and the Liebowitz Social Anxiety Scale Self-reported (LSAS-SR).ResultsThe internal validity of the A-RSQ is acceptable. The A-RSQ is positively and significantly correlated with the three reference scales: BSL-23, LSAS-SR and ECR-R. Factor analysis suggests a three-factor structure.ConclusionThis French version of the A-RSQ presents psychometric qualities comparable to its original version. This tool may be useful to researchers and clinicians interested in relationship problems, particularly in the context of borderline personality disorder where rejection sensitivity is a central process.     

Adaptation et validation française de l’inventaire de croyances et perceptions associées à la douleur: The pain beliefs and perceptions inventory (PBPI)

Beliefs have an important place to account for pain experience. Their evaluation constitutes a stake for physicians implied in the care of pain. In order to give care professionals a tool, we implement the French validation of the pain beliefs and perception inventory (PBPI) (Pain 36 [1989] 351–358). After translation, the French version was completed by chronic pain patients (n = 247) of a chronic pain center. A whole of analyses (sensitivity of items, factor analysis, estimation of the reliability of dimensions, sensitivity of dimensions) was carried out and confirmed the good psychometric qualities of the French version of the PBPI. Complementary analyses testify for the existing bond between experience of pain (felt pain, relief and variation of the pain) and pain beliefs. Additional works could be carried out to explore application perspectives of this tool.     

Transgender women’s experiences and beliefs about hormone therapy through and beyond mid-age: An exploratory UK study

Background: Little is known about transgender women’s beliefs and experiences of hormone therapy (HT), as part of their transition process, and particularly as they grow older. Aims: This study aimed to investigate: (i) transgender women’s experiences and attitudes to HT, and (ii) expectations of what might occur and/or what occurred after they reached “menopausal age.” Methods: Participants were recruited through invitations to an online survey sent to 138 Lesbian, gay, bisexual, transgender plus (LGBT+) support groups across the UK. Sixty-seven transgender women consented and completed the questionnaire; responses were analyzed using a mixed-methods approach. The beliefs about medicines questionnaire (BMQ) was used to assess beliefs about HT, while an inductive thematic qualitative approach was used to explore participants’ personal expectations and experiences of HT and their views about the menopause. Results: Participants were aged on average 49 years ranging from 20 to 79 years old. Most (96%) were taking HT. BMQ scores revealed strong beliefs about the necessity of HT and some concerns. Positive views about HT were expressed, with themes including treatment importance, personal and mental health benefits, but concerns about long-term effects, side effects, and maintaining access to the treatment were also mentioned. Views about menopause included uncertainty and questioning of its relevance; some mentioned changes to HT dosage, but most expected to use HT indefinitely. Discussion: This study provides exploratory qualitative and quantitative information about transgender women’s views about HT and menopause. Practical implications include improving access to HT and provision of evidence-based information about long-term use.     

French Adaptation and Validation of The Bullying Attitude Questionnaire in a sample of Primary School Teachers

IntroductionTeachers are the most likely people to intervene in bullying situations in primary schools. An effective and inexpensive way to measure the quality of their interventions during these incidents is the hypothetical scenario. However, there is no such validated measurement tool available in French.ObjectiveThe study objective was therefore to translate, adapt, and validate The Bullying Attitude Questionnaire among francophone primary school teachers.MethodThe participants were 37 female primary school teachers who completed the adapted version of The Bullying Attitude Questionnaire, translated in French by bilingual experts, as well as other scales used as external criteria.ResultsThe translated and adapted version of The Bullying Attitude Questionnaire showed good concurrent validity. Moreover, previous study conclusions using the same measurement tool were replicated in this study.ConclusionHypothetical scenarios represent a convenient way to measure the quality of teacher's interventions in bullying situations. In line with previous studies, teachers tend to perceive relational aggression as less severe than physical and verbal aggression. In such situations, they are less empathetic toward the victims, less upset with the perpetrator, and less likely to intervene.     

Validation française d’une échelle d’anxiété spécifique à la grossesse (PRAQ-R2)

ObjectivesPregnancy specific anxiety (PSA) may have many consequences on the health of the unborn child and the mother. Nowadays, in French, there is no validated tool to measure it. The aim of this study is to validate the French version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R2). This 10 items scale measures three PSA dimensions: worries about child health, fear of giving birth and concern about own appearance.MethodsAfter a translation and a back-translation step, the structural validity and the internal consistency of the scale were assessed in 160 pregnant women recruited online. Convergent validity (STAI-Y) and correlates of the construct were also examined.ResultsThe model fit indices are satisfactory, confirming the three- factor structure of the PRAQ-R2 in its French version. The dimensions and the total scores have a good internal consistency (α > .80), and convergent validity was also demonstrated.ConclusionThe PRAQ-R2 is the first tool designed to measure PSA and validated in France. This French validation has promising psychometric qualities. However, its discriminant validity and stability remain to be explored.     

What are the combined effects of negative emotions and illness cognitions on self-care in people with type 2 diabetes? A longitudinal structural equation model

Objective: To explore whether negative emotions mediate the effect of diabetes cognitions on diabetes self-care and conversely whether diabetes cognitions mediate the effect of negative emotions on diabetes self-care.

Design: Longitudinal observational study in adults with type 2 diabetes.

Main outcome measures: Self-reported depression and anxiety (Diabetes Wellbeing Questionnaire), cognitions (Illness Perceptions Questionnaire-Revised; Beliefs about Medicines Questionnaire), and diabetes self-care (Summary of Diabetes Self-Care Activities Scale) were completed at baseline and six months. Analyses used structural equation modelling.

Results: Baseline medication concerns were associated with elevated symptoms of depression and anxiety at follow-up, but emotions did not mediate medication concern’s effect on diabetes self-care. Baseline depression and anxiety symptoms were associated with specific diabetes cognitions over time, but these cognition domains did not mediate emotion’s effect on diabetes self-care. Personal control remained independent of emotions and was associated with diabetes self-care over time.

Conclusions: Negative emotions did not act directly or alongside cognitions to influence diabetes self-care. The reciprocal relationship between diabetes cognitions and emotions suggests cognitive restructuring, in addition to other mood management intervention techniques would likely improve the emotional wellbeing of adults with type 2 diabetes. Likewise, personal control beliefs are likely important intervention targets for improving self-care.     

The assessment of autistic traits with the Autism Spectrum Quotient: Contribution of the French version to its construct validity

IntroductionThe Autism Spectrum Questionnaire (AQ, Baron-Cohen et al., 2001) is a self-report assessment tool aiming at screening autistic traits in normal intelligence adults. While numerous versions in other languages than English now exist, few factorial evidence do sustain the valid use of this instrument as it was conceived, based upon five distinct dimensions (Social skills, Communication, Attention to detail, Attention switching, Imagination); no such study exists with a French version of the AQ. The aim of our study is therefore to present the French version of the scale and to explore its factorial validity with confirmatory factorial analyses and, possibly, its invariance across men and women.MethodSeveral confirmatory factorial analyses, with the robust WLSMV estimator for categorical response format, were run on the questionnaire data from 788 French-speaking students (17–25 years old) at university faculties or schools for higher education in Belgium. The original five-factor measurement model of the AQ was assessed as well as alternative models. An exploratory factorial analysis was also applied to get more insight as to possible sources of misfit.ResultsNo measurement model – neither the original five-factor one nor any of the six other models tested – did produce statistics or fit indices close to significant values: there was no fit to the data. The internal consistency of the subscales was weak; the exploratory factorial analysis further confirmed that as much as ten factors were needed to explain 45% of the data variance.ConclusionOur results, with a French version of the scale, add to many other ones which suggest that the AQ is a too heterogeneous questionnaire with somewhat ill-defined dimensions and non specific/ambiguous items. The questionnaire should probably be shortened and its content realigned to core features of the autism spectrum.     

Adherence to pharmacological treatment of non-malignant chronic pain: The role of illness perceptions and medication beliefs

The objective was to identify the degree to which illness perceptions and medication beliefs explain variations in reported adherence to medication prescribed for the treatment of non-malignant chronic pain and to test the applicability of an extended version of the self-regulatory model to the chronic pain population. A cross-sectional design included 217 clinic patients completing validated questionnaires assessing their illness perceptions, medication beliefs and reported adherence to medication. Perceptions of illness (pain) as chronic, uncontrollable and unremitting were associated with greater adherence, fewer medication concerns and a belief that treatment was necessary. Structural equation modelling supports an extended SRM for chronic pain. It suggests that patients holding perceptions of serious consequences of pain and high emotion levels have more concerns about medication and are less adherent. Perceptions of serious illness consequences are also associated with stronger beliefs about the necessity of medicines and greater adherence. Beliefs about illness and medication are associated with adherence to treatment in chronic pain and this can be explained by an extended SRM. Results are preliminary and require replication. Further studies should explore the role that emotion has on coping strategies in chronic pain. Interventions should focus on altering unhelpful beliefs that reduce adherence.     

Qualités psychométriques d’une version francophone du « Displaced Aggression Questionnaire »

IntroductionThe Displaced Aggression Questionnaire is currently the only self-report instrument to measure individual tendency to displace aggression. It is composed of three factors, which assess an affective dimension (angry rumination), a cognitive dimension (revenge planning) and a behavioral dimension (displaced aggression).ObjectiveTo adapt a French translated version of the Displaced Aggression Questionnaire and test the psychometrics.MethodIn this study, we recruited 191 adults in the community. The questionnaire has been adapted and validated with respects to guidelines for the process of transcultural adaptation and validation of self-report measures. A principal component analysis has been used to assess the structure of the French version of the questionnaire.ResultsAfter taking into account one item that has not loaded onto any of the three expected factors, the principal component analysis confirmed the hypothesized three-factor structure for the French version of the questionnaire according to the original structure of the scale. It has been named Questionnaire d’Agression Déplacée in French. Results showed good psychometric qualities for the internal consistency, the discriminant and concomitant validity and the reliability.ConclusionBased on these positive results, this version can already be used by French speaking researchers.     

Cross-cultural validation of a French version of the Emotional Processing Scale (EPS-25)

IntroductionThe Emotional Processing Scale (EPS) is a self-report questionnaire consisting of 25 items designed to identify emotional processing styles and impairments. The aim was to develop a French version of the scale and to test its preliminary validity and reliability in French community and clinical samples.MethodAfter translation and back-translation, a validation study was conducted with 1176 adults [215 from a community sample, 251 undergraduate psychology students, 686 people with a range of physical health conditions (HIV, multiple sclerosis, chronic pain, leukaemia) and 24 people with bipolar disorder hospitalised for depression].ResultsThe internal reliability of the French EPS was good, with a Cronbach's alpha of .91. The five-factor structure of the original English version of the scale was closely reproduced.ConclusionsThe French EPS demonstrated good reliability and validity. Correlations with other conceptually similar scales (e.g., TAS-20, CERQ, STAXI) were as predicted. EPS scores distinguished between groups (clinical samples vs. a community sample) that would be expected to differ.     

A French validation of the Child and Adolescent Mindfulness Measure (CAMM)

IntroductionA large number of studies have been devoted to the development of mindfulness questionnaires, a potential central mechanism in therapy. Although these questionnaires are well validated for adults, their accessibility to young populations are still in its infancy.ObjectiveThis study aims to validate a French version of the Child and Adolescent Mindfulness Measure (CAMM) to foster the use of mindfulness questionnaires in clinical studies on children and adolescents, and to fix limitations of a previous French-Canadian version.MethodA total of 545 youth aged from 10 to 17 were recruited in a Belgian and a French school in order to test the validity and reliability of the CAMM.ResultsThe results indicate a one-factor structure and suggest a good internal consistency. As expected, the CAMM was positively correlated to another mindfulness questionnaire and negatively correlated to depressive symptomatology and psychological inflexibility.ConclusionOverall, the French version of the CAMM presents good psychometric qualities and seems to remain faithful to its original scale. This measure could help to assess mindfulness in young French speakers.     

The Beliefs About Medication Scale: Development, Reliability, and Validity

The purpose of the study was to develop and evaluate a psychometrically sound health belief measure, the Beliefs About Medication Scale (BAMS) that can be used with adolescent chronic illness populations whose prescribed treatment includes oral medication. One hundred and thirty-three adolescents (age 11–18 years) with asthma (n = 60), HIV (n = 31), or inflammatory bowel disease (n = 42) completed the BAMS and, along with their parent, a self-report medication interview. A confirmatory factor analysis supported the hypothesized subscales of Perceived Threat, Positive Outcome Expectancy, Negative Outcome Expectancy, and Intent to Adhere to treatment. The subscales evidenced good internal consistency and 3-week test-retest reliability. Univariate and multivariate analyses demonstrated that the health belief constructs accounted for 22% of the variance in medication adherence beyond demographic and illness characteristics. The study provides preliminary evidence of the reliability and validity of a theoretically based measure of health beliefs for adolescents. The BAMS may be a useful tool to evaluate the psychological barriers to adherence that place teenagers at risk for nonadherence.     

Cross-cultural validity of the Five Facets Mindfulness Questionnaire: Adaptation and validation in a French-speaking sample

IntroductionRecent research has revealed that mindfulness training improves mental health and psychological functioning. Although several questionnaires have been developed to measure mindfulness, the Five Facets Mindfulness Questionnaire (FFMQ), [Baer et al., 2006. Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45] is currently one of the most empirically-based scale assessing mindfulness.ObjectiveThe present study was designed to: (1) test the psychometric properties and (2) explore the structural validation of the French version of the FFMQ.MethodTwo hundred and fourteen participants were tested using the French version of the FFMQ.ResultsUsing confirmatory factor analysis, the results showed the French version of the FFMQ has good psychometric properties and a structural validity similar to the initial version.ConclusionThis adaptation constituted a validated mindfulness measure for French-speaking clinicians as well as researchers.     

Validation of the French version of the Object Spatial Imagery and Verbal Questionnaire

IntroductionThe Object Spatial Imagery and Verbal Questionnaire (OSIVQ) measures individual differences in Visual-Verbal cognitive style and distinguishes between spatial and object visual imagery.ObjectiveThe aim of this study was to evaluate the psychometric properties of a French version of the OSIVQ.MethodSeven hundred fifty-two participants completed the French OSIVQ and 144 of them also completed a paper-and-pencil assessment to evaluate spatial imagery, object imagery and verbal abilities.ResultsPrincipal component analyses of the OSIVQ showed good internal construct validity. Results also revealed pronounced individual differences and a significant gender effect. Confirmatory factorial analyses gave support to a three-dimensional model of cognitive style. Furthermore, correlations were observed across the different dimensions of the questionnaire and specific paper-and-pencil tasks.ConclusionOur results highlight the good psychometric properties of the French version of the OSIVQ.     

Changing behaviors: Using norms to promote physical activity for type 2 diabetes patients

IntroductionGiven that diabetes is a major public heath issue around the world, it is vital that we find effective means to change behaviors, especially levels of physical activity among type 2 diabetes patients.ObjectiveThis study aims to provide proof of the effectiveness of programs promoting physical activity, based on cognitive dissonance and normative focus theories which are designed to produce behavioral changes in persons with type 2 diabetes.MethodNinety-six type 2 diabetes patients were assigned to one of three programs: a traditional information program, a norm-based program, and a dissonance-based program. The participants filled out a short French version of the International Physical Activity Questionnaire (IPAQ) one week before and one week after the program.ResultsThe results showed that the participants in the norm-based program made progress compared to those in the traditional information program. No significant difference was observed between the traditional information program and dissonance-based program.ConclusionsThese findings are consistent with both the focus normative theory and previous studies showing that recalling the norm increases compliance. The procedure to be used in diabetes prevention programs should focus on the normative dimensions of the desired behaviors in order to improve patients’ quality of life.