Psychometric properties of the questionnaire on threat perception of chronic illnesses in pediatric patients

Valero-Moreno, Selene; Lacomba-Trejo, Laura; Casaña-Granell, Sara; Prado-Gascó, Vicente Javier; Montoya-Castilla, Inmaculada; Pérez-Marín, Marian

doi:10.1590/1518-8345.3144.3242

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3144.3242 copy

Psychometric properties of the questionnaire on threat perception of chronic illnesses in pediatric patients^* * The publication of this article in the Thematic Series “Human Resources in Health and Nursing: Training and Practice in the Americas” is part of Activity 2.2 of Reference Term 2 of the PAHO/WHO Collaborating Center for Nursing Research Development, Brazil. Supported by Asociación Española de Psicología Clínica, Psicopatología e da Federación Española de Asociaciones de Terapia Familiar, el Programa VLC-BIOMED (Instituto de Investigación La Fe, Hospital Universitario y Politécnico La Fe y Universitat de València), la Ayuda de Iniciación a la Investigación de la Universitat de València y la Ayuda predoctoral de la Generalitat Valenciana (ACIF17) and by fondo social europeo, Spain.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

the objective of the study was to assess the psychometric properties of the Brief Illness Perception Questionnaire in a sample of adolescents with chronic endocrine or pneumological conditions and to analyze the dimensionality and reduce the scale elaborating scales by sex and medical diagnosis.

Method:

we evaluated 510 patients aged 9-16 years using the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. We carried out tests of reliability, construct and criterion validity and a comparison of means based on the diagnosis and socio-demographic variables. The reliability and validity analyses showed adequate psychometric properties for this scale, with better results obtained for a single dimension after eliminating 3 items.

Results:

adolescents with type 1 diabetes and girls were found to have an increased threat perception of their illness. Anxiety/depression was positively associated with the perception of illness.

Conclusion:

this questionnaire is a useful and practical tool for evaluating adjustment to illness in pediatric patients.

Descriptors:
Psycometrics; Endocrinology; Pediatrics; Pulmonary Medicine; Adaptation; Psychological

Solution or model		M^† † M = mean;	SD^‡ ‡ SD = Standard deviation;	r_jx^§ § rjx = Item-total correlation;	α-x^\|\| \|\| α-x = Cronbach's alpha without the item;	A^¶ ¶ A = Asymmetry;	K^ K = Kurtosis;
Unifactorial	Disease threat α^†† †† α= Cronbach's alpha (suitable ≥,70); = 0,56; α^†† †† α= Cronbach's alpha (suitable ≥,70); (without ítems 3, 4 and 7) = 0,76; ;CR^‡‡ ‡‡ CR = Composite reliability (suitable ≥,70) =0,82; CI^§§=(0,72-0,79); AVE^* * AVE = Index of extracted variance (suitable ≥,40); =0,57
	BIP-Q1	3,16	2,52	0,52	0,45	0,50	-0,45
	BIP-Q2	5,71	3,08	0,19	0,53	-0,05	-1,23
	BIP-Q3	3,55	3,11	0,15	0,57	0,78	-0,46
	BIP-Q4	1,86	2,24	0,09	0,57	1,37	1,48
	BIP-Q5	3,28	2,73	0,34	0,50	0,37	-0,86
	BIP-Q6	3,65	3,01	0,50	0,44	0,45	-0,87
	BIP-Q7	3,70	3,06	0,05	0,63	0,62	-0,58
	BIP-Q8	2,59	3	0,45	0,46	0,87	-0,46
Bifactorial	Cognitive: α^†† †† α= Cronbach's alpha (suitable ≥,70); = 0,38; α^†† †† α= Cronbach's alpha (suitable ≥,70); (without ítems 3 and 4) = 0,62; ;CR^‡‡ ‡‡ CR = Composite reliability (suitable ≥,70) =0,69; CI^§§=(0,56-0,67); AVE^* * AVE = Index of extracted variance (suitable ≥,40); =0,59)
	BIP-Q1	3,16	2,52	0,39	0,18	0,50	-0,45
	BIP-Q2	5,71	3,08	0,20	0,33	-0,05	-1,23
	BIP-Q3	3,55	3,11	0,06	0,45	0,78	-0,46
	BIP-Q4	1,86	2,24	0,11	0,39	1,37	1,48
	BIP-Q5	3,28	2,73	0,25	0,29	0,37	-0,86
	Afective: α^†† †† α= Cronbach's alpha (suitable ≥,70); = 0,68; α= 0,68 ;CR^‡‡ ‡‡ CR = Composite reliability (suitable ≥,70) =0,84; CI^§§=(0,62-0,73); AVE^* * AVE = Index of extracted variance (suitable ≥,40); =0,84)
	BIP-Q6	3,65	3,01	0,51	-	0,45	-0,87
	BIP-Q8	2,59	3	0,51	-	0,87	-0,46

Model	χ2^‡ ‡ χ2 = chi-square;	S-B-χ2^§ § S-B-χ2 = Robust correction of Satorra-Bentler chi-square;	gl\|^\| \| gl = Degrees of freedom;	p^¶ ¶ p = Level of significance;	S-B χ²/gl^ S-Bχ2/gl = Ratio between S-B χ2 and gl, Good fit≤5);	CFI^†† †† CFI = Comparative adjustment index (appropriate ≥,90);	IFI^‡‡ ‡‡ IFI = Bollet adjustment index (good fit≥0,90);	RMSEA^§§ §§ RMSEA = Mean quadratic approximation error (good fit: ≤0.08)
8 items (1 factor)	120.34	83.46	20	≤0.001	4.17	0.77	0.78	0.11(0.09-0.14)
8 items (2 factors)	218.78	136.06	12	≤0.001	11.33	0.53	0.55	0.20 (0.17-0.23)
5 items (1 factor without ítems 7,4,3)	12.94	8.12	5	0.15	1.62	0.99	0.99	0.05 (0.01-0.11)
5 items (2 factors without ítems 7,4,3)	12.85	8.58	4	0.07	2.15	0.98	0.98	0.07 (0.01-0.13)

BIP-Q^* * BIP-Q = Disease Threat Perception Questionnaire
For the following questions, please circle the number that best represents your opinion.
How much does your illness affect your life?
(Doesn't affect you at all) 0 1 2 3 4 5 6 7 8 9 10 (Seriously affects my life)
How long do you think your illness will last?
(Very little time) 0 1 2 3 4 5 6 7 8 9 10 (Forever)
To what extent do you feel symptoms due to your illness?
(Absolutely nothing to worry about) 0 1 2 3 4 5 6 7 8 9 10 (Extremely)
How worried are you about his illness?
(Absolutamente nada preocupado) 0 1 2 3 4 5 6 7 8 9 10 (Extremamente preocupado)
How emotional does your illness affect you? (That is, does it make you feel angry, scared, angry, or depressed?
(Not emotionally affected at all) 0 1 2 3 4 5 6 7 8 9 10 (Extremely emotionally affected)

	Perception of threat of disease (BIP-Q^* * BIP-Q = Disease threat perception questionnaire; )
Centile	DM1^† † DM1= Diabetes Mellitus Type 1; (n^‡ ‡ n = Group size; =113)		SS^§ (n^‡ ‡ n = Group size; =135)		Respiratory (n^‡ ‡ n = Group size; =241)		Centile
	Boys (n^‡ ‡ n = Group size; =62)	Girls (n^‡ ‡ n = Group size; =51)	Boys (n^‡ ‡ n = Group size; =81)	Girls (n^‡ ‡ n = Group size; =54)	Boys (n^‡ ‡ n = Group size; =124)	Girls (n^‡ ‡ n = Group size; =117)
90	37	33	26,80	25,50	29,50	34	90
80	29,40	28	18,32	21	25	29	80
70	24,20	25,40	18,32	18,32	23	26	70
60	21	24	17	17	20	23	60
50	18,32	18,32	13	14,50	16	20	50
40	18,32	18,32	11	12	13	17	40
30	18,32	18,32	8,60	9	10	14	30
20	18,32	18,32	7	6	7	12	20
10	13,60	13,20	4,20	3,50	5,50	8	10

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[1] Corresponding author: Marián Pérez-Marín. E-mail: marian.perez@uv.es