Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction--the Swedish version

When people's health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach's alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R's seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.     

An illness-specific version of the Revised Illness Perception Questionnaire in patients with atrial fibrillation (AF IPQ-R): Unpacking beliefs about treatment control,personal control and symptom triggers

Objective: This study modified the Revised Illness Perception Questionnaire (IPQ-R) in patients with persistent atrial fibrillation (AF).

Design: Qualitative interviews and think-aloud techniques informed modification of the IPQ-R to be specific to AF patients. Confirmatory Factor Analysis (CFA) (n = 198) examined the validity of the modified IPQ-R (AF-IPQ-R). Exploratory factor analysis (EFA) examined the new AF-triggers scale. Construct validity examined associations between the AF-IPQ-R, quality of life (QoL) and beliefs about medicines. Test–retest and internal reliability were examined.

Results: Interviews indicated that patients viewed triggers of AF rather than initial causes of illness as more applicable. Patients believed specific behaviours such as rest could control AF. Treatment control beliefs related to pharmacological and procedural treatments. These data were used to modify the IPQ-R subscales and to develop a triggers of AF scale. CFA indicated good model fit. EFA of the triggers scale indicated three factors: emotional; health behaviours; and over-exertion triggers. Expected correlations were found between the AF-IPQ-R, QoL and treatment beliefs, evidencing good construct validity.

Conclusion: The AF-IPQ-R showed sound psychometric properties. It provides more detailed specification than the IPQ-R of beliefs that may help to understand poor QoL in AF patients, and guidance for future interventions in this area.     

Factor analysis of the Revised Illness Perception Questionnaire in adults with atopic dermatitis

The objective of this study was to examine the psychometric properties of the revised Illness Perceptions Questionnaire (IPQ-R) in adult participants with atopic dermatitis (AD). Two hundred and eighty-four participants who had a GP or dermatologist confirmed diagnosis of AD completed the IPQ-R. The factor structure of the IPQ-R was examined using confirmatory (CFA) and exploratory factor analysis (EFA). The results of the CFA did not indicate a good comparative fit with the IPQ-R subscales, while the EFA and a fixed six-factor principal components analysis largely replicated the original factor structure of the IPQ-R. The existence of the acute/chronic and cyclical timeline dimensions, and the illness coherence subscale was most strongly supported, while all items of the consequences and emotional representation subscales consistently loaded onto one factor. The EFA for causal attributions did not produce a stable solution. The findings indicate that although the factor structure of the IPQ-R was not confirmed in the sample of patients with AD using CFA, it was partly reproduced using EFA. Overall, the results suggest that in patients with AD the IPQ-R, in particular the consequences and emotional representations subscales, should be employed and interpreted with care.     

Measuring Latinos' perceptions of depression: a confirmatory factor analysis of the Illness Perception Questionnaire

This study examined the psychometric properties of the Revised Illness Perception Questionnaire adapted for a clinical sample of low-income Latinos suffering from depression. Participants (N = 339) were recruited from public primary care centers. Their average age was 49.73 years and the majority was foreign born females of either Mexican or Central American descent. Confirmatory factor analysis was used to test the factor structure of this measure. Construct and discriminant validity and internal consistency were evaluated. After the elimination of three items because of low factor loadings (< .40) and the specification of seven error covariances, a revised model composed of 24 items had adequate goodness-of-fit indices and factor loadings, supporting construct validity. Each of the subscales reported satisfactory internal consistency. Intercorrelations between the 5 illness perception factors provided initial support for the discriminant validity of these factors in the context of depression. The establishment of the psychometric properties of this adapted measure will pave the way for future studies examining the role illness perceptions play in the help seeking and management of depression among Latinos.     

A systematic review and meta-analysis of the Brief Illness Perception Questionnaire

Objective: This paper aims to systematically review the use and performance of the Brief Illness Perception Questionnaire (Brief IPQ).

Design: Electronic databases were searched for papers administering the Brief IPQ published in peer-reviewed journals. Data were extracted from the results for meta-analysis.

Main outcome measures: Use by illness population, country, language and study design. The questionnaire’s concurrent validity, predictive validity, sensitivity to change, discriminant validity and mean scores for different populations were summarised.

Results: The review included 188 papers. The Brief IPQ has been administered to patients from age 8 to over 80, with a wide range of illnesses, in 26 languages from 36 countries. Pooled correlations between illness perceptions and depression, anxiety, blood glucose levels and quality of life were consistent with previous research and theory (range .25–.49 for consequences, identity and emotional representations; ?.12 to ?.27 for personal control). All items were able to predict some outcomes up to one-year follow-up. Each subscale demonstrated sensitivity to change after intervention in randomised controlled trials with the personal control and causal items showing most frequent change.

Conclusions: The Brief IPQ is widely used and has good psychometric properties. More studies should include and analyse the causal item.     

Measuring illness representations in breast cancer survivors (BCS) prescribed tamoxifen: Modification and validation of the Revised Illness Perceptions Questionnaire (IPQ-BCS)

Objective: The Revised Illness Perceptions Questionnaire (IPQ-R), widely used to assess illness perceptions, may fail to measure unique characteristics of different illnesses. This study modified and validated the IPQ-R for breast cancer survivors to provide detailed understanding of the specific illness perceptions held by these patients.

Design: Initial modifications were made following qualitative interviews and were revised in a think-aloud study. The modified scale was tested in 753 breast cancer survivors prescribed tamoxifen. Modifications included adding a tamoxifen consequences scale and adapting the timeline scales to measure beliefs around risk of recurrence and cure. A confirmatory factor analysis was conducted on the modified questionnaire and an exploratory factor analysis on the causal beliefs scale. Test–retest reliability, internal consistency and construct validity were also examined.

Results: The proposed eight-factor structure showed acceptable model fit, with high loadings and good reliability for all subscales. Correlations between subscales were consistent with theory and previous research.

Conclusions: The IPQ-BCS is valid and reliable, and provides unique understanding of specific perceptions held by this population, including beliefs surrounding risk of recurrence and consequences of ongoing hormonal treatment. Identifying these perceptions will aid development of interventions targeting depression, fear of recurrence and medication non-adherence.     

The importance of children's illness beliefs: the Children's Illness Perception Questionnaire (CIPQ) as a reliable assessment tool for eczema and asthma

A lack of information about disease in children can lead to erroneous views such as children believing that hospital admittance or the presence of a disease is a punishment for a perceived wrong. There has thus far been no standard tool available to measure children's illness conceptualizations from a Leventhalian framework. Three groups of children with eczema, asthma and eczema and asthma between the ages of 7 and 12 years of age were recruited. Children were given the Children's Illness Perception Questionnaire (CIPQ), a 26-item instrument adapted from the Illness Perception Questionnaire for adults. A Kuder - Richardson 20 test of reliability for dichotomous data was performed allowing an estimate of the internal consistency of the measurement scales. It can be seen that, for all three illness groups, internal consistency is acceptable for the timeline and consequences scale. The cure/control scale, however, was not internally consistent for any illness group. As health professionals, we need to develop the means to further understand how paediatric illness beliefs relate to specific disease types, age and psychosocial factors and the utility of this instrument is discussed within this context.     

Illness intrusiveness and quality of life in end-stage renal disease: comparison and stability across treatment modalities

Investigated the degree to which chronic, life-threatening illness and its treatment interfere with continued involvements in valued activities and interests--that is, illness intrusiveness--and its impact on quality of life in end-stage renal disease. Data were collected on two occasions separated by a lag of 6 weeks. Mixed analyses of variance indicated that life domains were affected differentially across treatments. Perceived illness intrusiveness correlated significantly with treatment time requirements, uremic symptoms, intercurrent nonrenal illnesses, fatigue, and difficulties in daily activities. Significant quality-of-life differences were observed across treatment modalities for satisfaction/happiness and pessimism/illness-related concerns but not for depression/distress. Perceived illness intrusiveness correlated significantly with each of these quality-of-life measures. Results were stable over time. These findings substantiate the construct of illness intrusiveness as a mediator of the psychosocial impact of chronic, life-threatening illness.     

Exploring the factor structure of the Mood and Anxiety Symptom Questionnaire (MASQ)

L. A. Clark and Watson (1991) proposed a tripartite model of anxiety and depression defined in terms of common symptoms relating to general distress, anxiety-specific symptoms of hyperarousal, and depression-specific symptoms of low positive affect and loss of interest. To aid the measurement of and discrimination between anxiety and depression they developed the Mood and Anxiety Symptom Questionnaire (MASQ). Although potentially useful, the MASQ is still in an early stage of development, and there is an indication that a discrepancy exists between items and scales. Therefore, the aim of this study was to explore the items and factors of the MASQ and determine whether a pattern similar to that suggested by L. A. Clark and Watson would emerge. Factor analysis of the MASQ revealed 3 factors relating to general distress, positive affect, and anxious arousal. Inspection of the individual items indicated that some refinements are required.     

Developing a Revised Cross-Cultural Academic Integrity Questionnaire (CCAIQ-2)

Understanding and measuring levels of academic integrity within higher education institutions across the world is an important area of study in the era of educational internationalization. Developing a cross-cultural measure will undoubtedly assist in creating standardization processes and add to the discourse on cross-cultural understanding on what constitutes honest and dishonest action in the higher education context. This study has used a combination of exploratory and confirmatory factor analytical procedures to validate a previously published questionnaire, namely the cross-cultural academic integrity questionnaire (CCAIQ). Inspection of response distributions was also undertaken. Primary participants in this study were from Iran (n?=?216), and secondary reference participants were from New Zealand (n?=?366) and Nigeria (n?=?330). The findings indicate that a revised questionnaire (CCAIQ-2) better represents the data obtained from all three regions. Three CCAIQ-2 domains are proposed: cheating, collusion and complying. However, the response distributions (skewness and kurtosis) indicated differences among the three groups, further suggesting that the theoretical constructs developed through factors analysis may not represent equivalence in terms of cross-cultural understanding. This research will inevitably create international debate on the measurement of integrity and how this measurement process can be used to establish internationally recognized and accountable educational regulations.     

Psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ)

The present study assesses the psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ). The questionnaire was administered to 598 healthy individuals from 15 different regions of Greece with a measure of socioeconomic characteristics and the Symptom Checklist-90-Revised (SCL-90-R). The sample was split into two random halves, and exploratory factor analysis indicated a three-factor solution. This solution was tested using a confirmatory factor analysis on the second half of the sample. In terms of latent dimensions, the Greek version retains the three-factor structure as proposed by the initial authors. However, adequate fit was achieved only after omitting eight items. The shorter (10-item) version was submitted to further analysis. The shorter version provided satisfactory internal reliability and evidence indicating the validity of the scale with respect to SCL-90-R subscales. The stability of the questionnaire was verified by a high test-retest reliability over a 3-mo. period (r = .86). Sex and age differences were assessed. The 10-item version appears to be a practical, brief tool for clinical use.     

Psychometric properties and validation of the Portuguese version of the Anxiety Control Questionnaire Revised (ACQ-R)

Current Psychology - Early experiences appear to influence the sense of unpredictability and uncontrollability of both life events and emotions in vulnerable individuals. The perception of low...     

Adolescent stress: Evaluation of the factor structure of the Adolescent Stress Questionnaire (ASQ‐N)

Moksnes, U. K., Byrne, D. G., Mazanov, J. & Espnes, G. A. (2010). Adolescent stress: Evaluation of the factor structure of the Adolescent Stress Questionnaire (ASQ‐N). Scandinavian Journal of Psychology, 51, 203–209. The present study reports an evaluation of the factor structure of the Norwegian version of the Adolescent Stress Questionnaire (ASQ‐N) among 723 students. Principal components analysis (PCA) revealed nine internally consistent dimensions of adolescent stress. Scales constructed from this PCA correlated positively with measures of depression and anxiety and negatively with self‐esteem. Girls reported higher stress levels than boys in seven of the nine scales and age was also positively correlated with the scale scores of adolescent stress. The results revealed that the instrument has potential for measuring adolescent stress. The stability of the ASQ‐N needs to be tested repeatedly, across cohorts and over time, to establish the adequacy for use in Norwegian adolescent studies.     

The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population

The purpose of this study was to analyze the internal consistency and the external and structure validity of the 12-Item General Health Questionnaire (GHQ-12) in the Spanish general population. A stratified sample of 1001 subjects, ages between 25 and 65 years, taken from the general Spanish population was employed. The GHQ-12 and the Inventory of Situations and Responses of Anxiety-ISRA were administered. A Cronbach's alpha of .76 (Standardized Alpha: .78) and a 3-factor structure (with oblique rotation and maximum likelihood procedure) were obtained. External validity of Factor I (Successful Coping) with the ISRA is very robust (.82; Factor II, .70; Factor III, .75). The GHQ-12 shows adequate reliability and validity in the Spanish population. Therefore, the GHQ-12 can be used with efficacy to assess people's overall psychological well-being and to detect non-psychotic psychiatric problems. Additionally, our results confirm that the GHQ-12 can best be thought of as a multidimensional scale that assesses several distinct aspects of distress, rather than just a unitary screening measure.     

Validation of the factor structure of the Greek adaptation of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3)

The current study aimed to confirm the factor structure and reliability of the newly translated Greek version of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) among 1753 Greek-Cypriot high school students. Results of the structural equation modeling indicated a very good fit with the original four-factor structure of the SATAQ-3 for both males and females. The Cronbach's alpha coefficients for the four subscales were .92 for ‘Internalization-General’, .82 for ‘Internalization-Athlete’, .94 for ‘Pressure’ and .88 for ‘Information’. Further analyses showed no significant differences between BMI categories with respect to the Internalization-General, Internalization-Athlete and Information factors but there were significant differences on the Pressure factor. The findings of the current study support the existence of the original four-factor structure of the SATAQ-3. The validity and reliability results of the Greek version of the SATAQ-3 support its use in Greek-speaking countries or populations.     

Sex differences in the factor structure of a modified Sexual Experiences Questionnaire

Sexual harassment has long been a problem in educational, employment, and military populations. It is unclear whether existing questionnaires used to measure sexual harassment in the U.S. military--particularly, derivatives of the Sexual Experiences Questionnaire--perform similarly in men and women. Using exploratory factor analyses in a mixed sample of active duty troops and veterans (289 men, 181 women), sex differences were found in one version's factor structure. Implications and suggestions for improving the validity of the questionnaire for men are offered.     

Assessing hopelessness in terminally ill cancer patients: development of the Hopelessness Assessment in Illness Questionnaire

Hopelessness has become an increasingly important construct in palliative care research, yet concerns exist regarding the utility of existing measures when applied to patients with a terminal illness. This article describes a series of studies focused on the exploration, development, and analysis of a measure of hopelessness specifically intended for use with terminally ill cancer patients. The 1st stage of measure development involved interviews with 13 palliative care experts and 30 terminally ill patients. Qualitative analysis of the patient interviews culminated in the development of a set of potential questionnaire items. In the 2nd study phase, we evaluated these preliminary items with a sample of 314 participants, using item response theory and classical test theory to identify optimal items and response format. These analyses generated an 8-item measure that we tested in a final study phase, using a 3rd sample (n = 228) to assess reliability and concurrent validity. These analyses demonstrated strong support for the Hopelessness Assessment in Illness Questionnaire providing greater explanatory power than existing measures of hopelessness and found little evidence that this assessment was confounded by illness-related variables (e.g., prognosis). In summary, these 3 studies suggest that this brief measure of hopelessness is particularly useful for palliative care settings. Further research is needed to assess the applicability of the measure to other populations and contexts.     

Confirmatory factor structure and measurement invariance of the Memory Compensation Questionnaire

Recent research with the Memory Compensation Questionnaire (MCQ) has examined changes, functions, and correlates of compensatory strategy use in older adults. The twofold aim of this study was to test (a) the hypothesized structure of the MCQ and (b) structural equivalence across age, gender, and time. The 7-scale MCQ was designed to measure 5 compensatory mechanisms and 2 general aspects of compensatory awareness. The authors assembled a 3-wave (6-year) sample (N = 521; age = 55-85 years) from the Victoria Longitudinal Study. The results of structural equation modeling supported (a) the a priori structure of the MCQ and (b) the inference of measurement invariance across the 3 dimensions. Accordingly, the MCQ is available for measuring self-reported efforts to compensate for everyday memory losses.     

The influence of different dialysis modalities on the quality of life of patients with end-stage renal disease: A systematic literature review

Objectives: This study aims to generate evidence regarding the relationships of different dialysis modalities with HR-QOL.

Design: A systematic review was conducted to investigate the HR-QOL of patients treated with different dialysis modalities.

Methods: A literature search was conducted for English language articles in the CINAHL, Medline and PubMed databases published from January 1990 through May 2016. Specifically, we sought articles that would compare the HR-QOL of hemodialysis (HD) and peritoneal dialysis (PD) patients in terms of physiological, psychological and social functioning, as well as disease symptoms. Thirty-four articles met the study inclusion criteria and were included into the analysis.

Results: The research results indicated no significant differences in HR-QOL between HD and PD treatment. However, a higher percentage of patients who received PD had a better HR-QOL in terms of physiological, psychological, social and disease symptoms.

Conclusions: Despite the fact that the results of this study showed no difference in HR-QOL between HD and PD treatment, its review of relevant references can serve as a reference for health professionals. However, patients’ conditions must still be taken into account when making suggestions about which dialysis modality a patient should use.