Validity and reliability of a Malay version of the brief illness perception questionnaire for patients with type 2 diabetes mellitus

Cognitive and Emotional Perceptions of Illness in Patients Diagnosed with Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) affects a patient's physical, social, and mental well-being. Perceptions of the illness are linked to quality of life. The aim of this study was to assess illness perception in patients diagnosed with T2DM and to validate the Brief Illness Perception Questionnaire in the Slovenian language. A cross-sectional study involved 141 patients diagnosed with T2DM. We performed a content analysis of the questionnaire and estimated the S-CVI, I-CVI, kappa coefficient. We also used Cronbach's alpha to assess the reliability. Participants did not have a very threatening perception of T2DM, but being overweight and having cardiovascular disease were significant contributors to a more threatening perception. The most frequently indicated factors influencing the onset and development of T2DM were heredity and genetics, stress and other psychological distress, and poor and inadequate nutrition. I-CVI ranged from 0.833 to 1.00, while the kappa is greater than 0.74, confirming the excellent validity of the questions. The content validity assessment of the questionnaire further confirms that the questionnaire is suitable for use with the target population in Slovenia. The questionnaire proved to be a valid and reliable tool that can be used to assess the relationship between illness perception and self-management of T2DM.

Psychometric properties of the Malay version of the Illness Cognition Questionnaire among cancer patients in Malaysia

OBJECTIVE

The Illness Cognition Questionnaire (ICQ) was translated from its original English version to the Malay version for this research, adapted the Malay language version of the ICQ (ICQ-M) for use in cancer patients, and assessed the internal consistency, content, face, construct, convergent, discriminant and concurrent validity of the ICQ-M among a cohort of cancer patients with mixed cancer types in Malaysia.

METHOD

Initially, the ICQ was translated into Malay and back-translated, and its content and face validity were evaluated. Then, 346 cancer patients with various cancer types received the ICQ-M, and its internal consistency, convergent, discriminant, construct, and concurrent validity were evaluated.

RESULTS

The ICQ-M and its domains had acceptable internal consistency with Cronbach's α ranging from 0.742 to 0.927. Construct validity assessment demonstrated that the ICQ-M consists of 17 items designated in two domains with good convergent and discriminant validity. The ICQ-M and its domains also had moderate correlations with the Acceptance and Action Questionnaire II, which denotes that the ICQ-M had acceptable concurrent validity.

CONCLUSION

The ICQ-M had good psychometric properties and is now available to measure the illness cognition of cancer patients in Malaysia.

Design and validation of a Questionnaire on the factors influencing self-care behaviors in patients with Multiple sclerosis (QFASMS)

BACKGROUND

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Since MS does not have a definitive cure, individuals affected by it need to adapt and coordinate with their chronic illness in order to fulfill their duties and responsibilities. The first step in helping patients to better care for and manage their illness is to engage in self-care behaviors. This study was conducted with the aim of design and validation of a questionnaire on the factors influencing self-care behaviors in patients with Multiple sclerosis.

METHODS

This cross-sectional study was conducted on Multiple sclerosis patients in Iran in 2023. The age range of patients varied between 22 and 52 years. Having MS disease, passing one year of the disease duration, living in Mashhad city, having informed consent to participate in the study and not completing the questionnaire were the entry and exit criteria of the study.

RESULTS

This study was conducted on 500 patients with multiple sclerosis. Based on the results of psychometrics (face, content and construct validity), the number of questions was reduced from 120 to 47 questions and 73 questions were eliminated. Finally, the questionnaire was approved with 47 questions and 4 subscales of understanding the symptoms of the disease (9 questions), tendency to conscious and targeted care (21 questions), laziness in care (8 questions) and tendency to receive therapy services (9 questions). Cronbach's alpha and McDonald's omega index for all questionnaire questions were 0.877 and 0.881, respectively.

CONCLUSIONS

Based on the results of this questionnaire, 47 questions and 4 subscales can be used to measure the factors influencing the adoption of self-care behaviour's in patients with multiple sclerosis.

Evaluating the Turkish validity and reliability of the Brief Illness Perception Questionnaire in periodontal diseases

Background

The Brief Illness Perception Questionnaire (Brief IPQ) is a widely used multifactorial scale that assesses the individuals' perceptions of illness. Although there are studies investigating the psychometric properties of the Brief IPQ in many languages, the Turkish version of Brief IPQ on periodontal diseases has not been revealed so far. This study aimed to evaluate the Turkish validity and reliability of the Brief IPQ and contribute to the literature. It is also aimed to evaluate the patients' illness perception with periodontal disease and to reveal the possible effects of the disease on the patients' daily life.

Methods

This cross-sectional study was conducted with 209 patients with periodontal diseases (137 gingivitis and 72 periodontitis cases). Sociodemographic characteristics and clinical periodontal measurements of all patients were recorded. The Turkish versions of the Brief IPQ and the HAD Scale were applied to the patients via face-to-face. The construct validity was determined using confirmatory factor analysis. Test-retest reliability and internal consistency were performed using ICC test and Cronbach's alpha, respectively. The concurrent validity was determined by using Spearman's correlation coefficient.

Results

The confirmatory factor analysis showed that the scale has one factor. The Spearman's correlation coefficient results were found 0.843 and 0.854 for concurrent validity. Cronbach's alpha value of the scale was 0.944 in the internal consistency analysis. ICC value was found to be 0.987 for test-retest reliability. Floor/ceiling effects were considered not to be present.

Conclusions

It was found that the Turkish version of The Brief Illness Perception Questionnaire is valid and reliable. Brief IPQ may be used to determine the illness perception in patients with periodontal diseases.

Improving physical and psychological outcomes of cardiac patients using the Naluri app: A study protocol for a randomized controlled trial

Background: Coronary artery disease (CAD) continues to be a significant burden to public health. Poor treatment and management can lead to more severe cardiac events that could result in death or disability. Early interventions like cardiac rehabilitation programs can provide patients the required knowledge, skills and support to recover from and prevent more cardiac events. Electronic health (eHealth) interventions have potential to complement hospital-based rehabilitation programs. This study aims to investigate the effectiveness of the Naluri app in improving health behaviours, clinical and psychological outcomes in a sample of cardiac patients in Malaysia. Methods: This study is a two-arm, parallel, superiority randomized control trial to be conducted at the Malaysian National Heart Institute. A total of 200 patients will be randomly assigned to either a 16-week theory-based Naluri app in addition to usual care (treatment) or to usual care only (control). Outcomes will be measured at baseline and at 16 weeks. Health behaviour outcomes include physical activity and diet. Clinical outcomes include BMI, hemoglobin A1c (HbA1c), and lipid levels. Psychological outcomes include anxiety, depression, and health related quality of life (HRQOL). The Naluri app theoretical framework is based on the Health Action Process Approach (HAPA) theory. Risk perception, self-efficacy, planning, intentions, outcome expectancies, illness perceptions and psychological outcomes will be measured using self-reported measures. Discussion: This trial will determine the effectiveness of the Naluri app intervention in improving various outcomes of cardiac patients after four months. It will provide data on the applicability of the HAPA theory in Mobile health (mHealth) intervention and the acceptance and efficacy of mHealth as a cardiac rehabilitation program for patients in Malaysia. The results may inform the potential implementation of the app for use with patients with other chronic illnesses like diabetes, stroke, and depression. Registration: Australia New Zealand Clinical Trials Registry (14/01/2019, ACTRN12619000104156).

Developing a questionnaire for diabetes mellitus type 2 risk effects and precondition factors – multivariate statistical paths

The primary purpose of the present study is to summarize and explain the results of a questionnaire about diabetes mellitus type 2 (DMT2) endangered individuals. The 275 participants (age between 21 and 76 years) answered 18 questions related to the possible danger of DMT2 disorder. Multivariate statistical methods – cluster analysis, factor and principal components analysis applied for the survey analysis. The final goal was to detect similarity patterns between the variables of interest (questions), to reveal hidden factors regulating the data structure and susceptibility to DMT2 among the participants or between them, to elucidate the health status of the different groups and the similarities within the groups. It was found that five hidden factors regulate the data structure, which are conditionally named “declined general health status”; “metabolic syndrome factor”; “smoking, alcohol abuse and stress factor”; “heredity and sex impact”; “healthy food” impact. The participants could be divided into four similarity patterns, each with probably different susceptibility to DMT2. Thus, the results of the questionnaire could be of use for prophylactic purposes.

Psychometric properties of the Persian version of the brief illness questionnaire in Iranian with non-specific chronic neck pain

INTRODUCTION

The Brief Illness Perception Questionnaire (BIPQ) is an instrument for assessing the illness perception. Illness perception varies between individuals based on their health status. There is no study that assess the psychometric properties of the Persian version of BIPQ in neck pain patients. The goal of this study was to evaluate the reliability, construct validity, and exploratory factor analysis of the Persian BIPQ in individuals with non-specific chronic neck pain.

METHODS

This is a cross-sectional study in which 123 individuals with non-specific chronic neck pain participated. 60 participants examined after 7 days for testing reliability. Reliability was assessed by intra-class correlation coefficient, standard error of measurement, and minimal detectable change. For assessing construct validity and item-total correlation, correlation tests were used. Also, exploratory factor analysis was done to assess the factor structure of the BIPQ.

RESULTS

Exploratory factor analysis' results showed that there were 2 factors with Eigenvalues >1. Factor 1 included "identity", "consequence", "timeline", and "emotional response". Factor 2 consisted of "coherence" and "treatment control". The intra-class correlation coefficient and the cronbach's alpha for the total score was 0.8 and 0.86 respectively. Results of correlation tests showed an acceptable construct validity except with SF-12 mental component. Item-total correlation tests demonstrated that the correlations were above 0.3 for all subscales except for "treatment control" and "coherence".

CONCLUSION

BIPQ has an acceptable properties to assess illness perception in individuals with non-specific chronic neck pain. The results of exploratory factor analysis and item-total correlation confirmed that 2-subscale version is more acceptable.

Psychometric Testing of the Bahasa Version of the Brief Illness Perception Questionnaire among Indonesians with Type 2 Diabetes Mellitus

The Brief Illness Perception Questionnaire (B-IPQ) has been recommended to validate illness perception. Nevertheless, this measurement has yet to be validated with an assessment of the construct and convergent validities and reliability in Indonesia. Our study aimed to psychometrically test the 8-item B-IPQ among Indonesians with type 2 diabetes mellitus (T2DM). Data included 294 patients with T2DM with stratified multistage clustering. The 36-item Short Form Survey, 21-item Depression Anxiety Stress Scale, and fasting blood glucose (FBG) were used to examine convergence and divergence. The validity analysis included the construct and convergent validities with significant person correlations. Cronbach's alpha, composite reliability (CR), and average variance extracted (AVE) were used to assess reliability. Confirmatory and exploratory factor analyses indicated a multidimensional structure, including cognitive with a five-item structure and emotional illness representation with a three-item structure, with an acceptable goodness of model fit. The tool revealed good internal consistency for the cognitive, emotional, and overall domains and was positively moderately correlated with FBG, stress, anxiety, and depression but negatively correlated with the overall quality of life and mental and physical component scores. Findings provide empirical evidence that the Bahasa version of the B-IPQ showed adequate internal consistency, exploratory and confirmatory, and thus is valid and reliable for illness perception assessments among Indonesians with T2DM.

Protocol for a qualitative study exploring the perception of need, importance and acceptability of a digital diabetes prevention intervention for women with gestational diabetes mellitus during and after pregnancy in Malaysia (Explore-MYGODDESS)

INTRODUCTION

Women who develop gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes, and to reduce this risk the women have to adopt healthy behaviour changes. Although previous studies have explored the challenges and facilitators to initiate behaviour change among women with GDM, there is limited data from Malaysian women. Thus, this study will explore the factors affecting the uptake of healthy behaviour changes and the use of digital technology among women and their healthcare providers (HCPs) to support healthy behaviour changes in women with GDM.

METHODS AND ANALYSIS

The study will be modelled according to the Capability, Opportunity, Motivation and Behaviour and Behaviour Change Wheel techniques, and use the DoTTI framework to identify needs, solutions and testing of a preliminary mobile app, respectively. In phase 1 (design and development), a focus group discussion (FGDs) of 5-8 individuals will be conducted with an estimated 60 women with GDM and 40 HCPs (doctors, dietitians and nurses). Synthesised data from the FGDs will then be combined with content from an expert committee to inform the development of the mobile app. In phase 2 (testing of early iterations), a preview of the mobile app will undergo alpha testing among the team members and the app developers, and beta testing among 30 women with GDM or with a history of GDM, and 15 HCPs using semi-structured interviews. The outcome will enable us to optimise an intervention using the mobile app as a diabetes prevention intervention which will then be evaluated in a randomised controlled trial.

ETHICS AND DISSEMINATION

The project has been approved by the Malaysia Research Ethics Committee. Informed consent will be obtained from all participants. Outcomes will be presented at both local and international conferences and submitted for publications in peer-reviewed journals.

Cultural Responses to Covid-19 Pandemic: Religions, Illness Perception, and Perceived Stress

Many psychological researchers have proven the deteriorating effects of the coronavirus disease 2019 (Covid-19) pandemic on public mental health. In Malaysia, various Covid-19 clusters were associated with religious gatherings. From a cultural psychology perspective, how ethno-religious groups respond to this crisis originating from their unique rationality and ecological systems. Therefore, this study aimed to explore the illness perceptions of major religious groups (Christian, Muslim, and Buddhist) in Malaysia toward the Covid-19 pandemic, their stress levels, and the relationship between illness perception, stress, and forms of religious expression during the lockdown period. Through an online survey method, 608 Malaysian religious believers were included in this mixed-method empirical study, which adapted standardized instruments [Duke University Religion Index (DUREL), Brief Illness Perception Questionnaire (BIPQ), and Perceived Stress Scale (PSS)]. Statistical analysis showed that all three groups reported moderate levels of stress in average without any significant difference after controlling for age. Both internal and external forms of religious expression had a significant negative relationship with stress levels. Personal control, comprehension, and emotions domains of illness perception accounted for a significant variance in the stress level. Furthermore, religious expression significantly moderated the relationship between some illness perception domains and stress. Qualitative coding revealed that most participants perceived human behavior and attitudes, sociopolitical, and sociological factors as causal factors to the current pandemic. These findings confirmed the relationship between religious expression, illness belief, and stress regulation during the pandemic lockdown. Incidental findings of age as a potential protective factor for Malaysian believers warrants further study. In the conclusion, implications for public health policymakers and religious communities on pandemic prevention and well-being promotion were discussed.

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

BACKGROUND

The management of diabetes is complex. There is growing recognition of the use of patient-reported outcome measures (PROMs) as a standardized method of obtaining an outlook on patients' functional status and well-being. However, no systematic reviews have summarized the studies that investigate the measurement properties of diabetes PROMs.

OBJECTIVE

Our aims were to conduct a systematic review of studies investigating the measurement properties of diabetes PROMs by evaluating the methodological quality and overall level of evidence of these PROMs and to categorize them based on the outcome measures assessed.

METHODS

This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the Embase, PubMed, and PsychINFO databases. The PROMs were evaluated with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines.

RESULTS

A total of 363 articles evaluating the measurement properties of PROMs for diabetes in the adult population were identified, of which 238 unique PROMs from 248 studies reported in 209 articles were validated in the type 2 diabetes population. PROMs with at least a moderate level of evidence for ≥5 of 9 measurement properties include the Chinese version of the Personal Diabetes Questionnaire (C-PDQ), Diabetes Self-Management Instrument Short Form (DSMI-20), and Insulin Treatment Appraisal Scale in Hong Kong primary care patients (C-ITAS-HK), of which the C-PDQ has a "sufficient (+)" rating for >4 measurement properties. A total of 43 PROMs meet the COSMIN guidelines for recommendation for use.

CONCLUSIONS

This study identified and synthesized evidence for the measurement properties of 238 unique PROMs for patients with type 2 diabetes and categorized the PROMs according to their outcome measures. These findings may assist clinicians and researchers in selecting appropriate high-quality PROMs for clinical practice and research.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42020180978; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180978.

Reliability and Validity of the Brief Illness Perception Questionnaire in Bahasa Malaysia for Patients with Cancer

OBJECTIVE

The main purpose of this study was to identify the psychometric properties and validate   the Bahasa Malaysia version of the Brief Illness Perception Questionnaire among patients with cancer.

METHODS

A total of 129 newly diagnosed patients with cancer were consecutively sampled. Reliability and validity of the questionnaire were tested using translation validity, test-retest reliability, Principal Component Analysis, Cronbach's alpha coefficient for domains and item-total correlation.

RESULTS

The questionnaire indicates excellent test-retest reliability. The Principal Component Analysis (PCA) revealed that Kaiser-Meyer-Olkin (KMO) is 0.60 for the two-factor structure of the Brief Illness Perception Questionnaire of the Bahasa Malaysia version which consists of cognitive illness representation and emotional illness representation.

CONCLUSION

The Brief Illness Perception Questionnaire in the Bahasa Malaysia version is a useful tool to use among patients with cancer in Malaysia context despite moderate psychometric properties. This is based on the premise that the questionnaire can be used as a quick tool to assess illness perceptions among Malaysian with cancer in routine oncology practice.

The Persian Brief Illness Perception Questionnaire: Validation in Patients with Chronic Nonspecific Low Back Pain

BACKGROUND

Illness perceptions may influence coping behaviors as well as treatment and recovery among patients with chronic pain including low back pain (LBP). These perceptions may vary across different conditions. The Brief Illness Perception Questionnaire (BIPQ) is used as an instrument to assess the patients' perception of illness. Although the BIPQ has been previously translated into Persian, its psychometric properties have not been evaluated among patients with chronic nonspecific LBP. The aim of this study was to determine the reliability and validity of the Persian BIPQ in patients with chronic nonspecific LBP.

METHODS

116 patients with chronic nonspecific LBP with a mean (standard deviation) age of 36.4 years (10.7) participated in this cross-sectional study. Fifty patients were reexamined after 10 to 12 days for test-retest reliability. Internal consistency reliability, construct validity, concurrent criterion validity, and structural validity were evaluated. The concurrent validity was examined by using the Short Form-36 Health Survey.

RESULTS

There were no floor and ceiling effects. Cronbach's alpha for the total score was 0.90. The intraclass correlation coefficient (ICC) for test-retest reliability was 0.90. The standard error of measurement and the minimal detectable change was found to be 3.26 and 9.04, respectively. The convergent correlations confirmed the construct validity. The concurrent criterion validity was demonstrated by significant negative correlations with the SF-36. The Exploratory Factor Analysis produced the 2 factors (emotional illness representations and cognitive illness representations) with an eigenvalue >1.0 that jointly accounted for 58.86% of the total variance.

CONCLUSION

The Persian BIPQ is a reliable and 2-factor instrument and can be used for assessing illness perception in patients with chronic nonspecific LBP.

An Evaluation of the Video Narrative Technique on the Self-Efficacy of Medication Understanding and Use Among Post-Stroke Patients: A Randomized-Controlled Trial

INTRODUCTION

Self-efficacy is positively associated with medication understanding and use self-efficacy (MUSE) among post-stroke patients. It is also closely related to knowledge, belief, and perception, which vary among people from different socioeconomic backgrounds and cultures. As interventions using video and peer stories have emerged to be successful on behavior modification, this study aimed to explore the effectiveness of video narratives incorporated with Health Belief constructs on MUSE and its associated factors among patients with stroke at a local setting.

METHODS

A randomized controlled trial (RCT) for 12 months was carried out on patients diagnosed with stroke at Hospital Kuala Lumpur, Malaysia. The RCT recruited up to 216 eligible patients who were requested to return for two more follow-ups within six months. Consented patients were randomized to either standard care or intervention with video narratives. The control of potential confounding factors was ensured, as well as unbiased treatment review with prescribed medications, only obtained onsite.

RESULTS AND DISCUSSION

A repeated measure of MUSE mean score differences at T0 (baseline), T2 (6th month) and T4 (12th month) for antithrombotic, antihypertensive, and all medication categories indicated significant within and between groups differences in the intervention group (p<0.05). Moreover, this impact was reflected upon continuous blood pressure (BP) monitoring compared to the control group (F (1214) =5.23, p=0.023, ƞ2=0.024). Though BP measure differences were non-significant between the groups (p=0.552), repeated measure analysis displayed significant mean differences between intervention and control group on BP control over time (F (1.344, 287.55) =8.54, P<0.001, ƞ2=0.038). Similarly, the intervention's positive impact was also present with similar trends for knowledge, illness perception, and the belief about medicine. Though significant differences (p<0.05) of all outcome measures gradually decreased between T2 and T4 in the intervention group; nevertheless, these positive findings confirmed that personalized video narratives were able to motivate and influence MUSE and its associated factors among post-stroke patients. The significant improvement in medication-taking self-efficacy and the sustenance of BP monitoring habits among patients in the intervention group strengthened our conceptual framework's practicality.

A cross-sectional study on the rate of non-adherence to anti-seizure medications and factors associated with non-adherence among patients with epilepsy

Background

Non-adherence to anti-seizure medication (ASM) therapy is an important contributing factor to the higher mortality rate and treatment failure of epilepsy. This study aimed to determine the rate and factors associated with non-adherence to ASM therapy through the WHO five dimensions of medication adherence framework.

Methods

We conducted a cross-sectional study at an outpatient Neurology Clinic of a tertiary government hospital in Malaysia. Between March and July 2019, we identified 217 patients with a confirmed diagnosis of epilepsy, receiving oral ASM therapy and able to administer their medications. We performed a semi-structured interview to gather information on sociodemographic background, clinical and medication history, and perceptions on healthcare services. Adherence to ASM therapy was evaluated using the Medication Compliance Questionnaire (MCQ). Patient’s illness perception was assessed by the Brief Illness Perception Questionnaire (B-IPQ).

Results

208 patients participated in this study. The median age of the study participants was 35 years (IQR 26–44). 58.2% were females and majority, 55.8%, were from the Malay ethnic group. Based on the MCQ scoring, 89 patients (42.8%) were non-adherent. Multiple logistic regression demonstrated that being employed or students (adjusted odds ratio [aOR] 2.26, 95%CI: 1.19–4.29 p = 0.012) and having an average or below average perceived access to pharmacy services (aOR 2.94, 95%CI: 1.38–6.24, p = 0.005) were significant contributors to non-adherence.

Conclusion

Being employed or students and having an average or below average perceived access to pharmacy services were associated with ASM non-adherence Efforts to improve ASM adherence should adopt a comprehensive approach considering the success of adherence is contingent on the interrelationship of multiple dimensions.

Questionnaire on Perception of Threat from COVID-19

The ravages caused by the disease known as COVID-19 has led to a worldwide healthcare and social emergency requiring an effective combined effort from everyone to reduce contagion. Under these circumstances, the perception of the disease is going to have a relevant role in the individual’s psychological adjustment. However, at the present time there is no validated instrument for evaluating adult perception of threat from COVID-19. Considering the importance of perception or representation of the disease in a state of social alert, our study intended to validate an instrument measuring the psychological process of the disease caused by the coronavirus (COVID-19). In view of the above, this study evaluated the factor structure and reliability of the version of the Illness Perception Questionnaire (IPQ) for COVID-19 in a sample of adults. The sample consisted of 1014 Spanish adults (67.2% women and 32.8% men). The exploratory and confirmatory factor analyses supported a unidimensional model of the scale, which was the one that showed the best fit and explained 43.87% of the variance. This brief version has adequate psychometric properties and may be used to evaluate the perception of threat from COVID-19 in an adult Spanish population. The validation of this instrument contributes to progress in representation of COVID-19 in our culture.

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

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.

Factors influencing self-management behaviours among patients with type 2 diabetes mellitus in the Solomon Islands

AIMS AND OBJECTIVES

This study aims to explore the current state of self-management behaviours among persons with type 2 diabetes mellitus in the Solomon Islands and to discuss the factors influencing these behaviours.

BACKGROUND

The prevalence of diabetes and diabetes complications is increasing in the Solomon Islands. However, the effective diabetes prevention and care are not provided in the country.

DESIGN

This is a cross-sectional study.

METHODS

A convenience sample of 150 persons with type 2 diabetes mellitus was recruited from a hospital in the Solomon Islands from August 2017-September 2017. Self-report questionnaires were used to measure the self-management behaviours, diabetes knowledge and illness perception. In addition, the study adhered to the EQUATOR checklist, STROBE (see Appendix S1).

RESULTS

The overall score for self-management was 56.9 ± 13.2 and diabetes knowledge and illness perception, as influencing factors of self-management, earned total scores of 13.3 ± 4.0 and 55.8 ± 12.0, respectively. Stepwise regression analysis identified illness perception, diabetes knowledge and smoking as significant influencing factors, explaining 20.8% of the total variance in self-management.

CONCLUSIONS

The level of diabetes self-management behaviours demonstrated by persons with type 2 diabetes mellitus in this study was rated as less than ideal. Diabetes knowledge and illness perception were the two main factors influencing patient self-management in the Solomon Islands.

RELEVANCE TO CLINICAL PRACTICE

The study addressed the current state of the self-management behaviours of persons with diabetes and discussed the factors influencing these behaviours. The findings indicated that knowledge and illness perception of diabetes were the two main factors and provided baseline information for policymakers, health planners and healthcare providers highlighting diabetes as an important issue in Solomon Islands.

A network analysis of the Brief Illness Perception Questionnaire in patients with rheumatic diseases and human immunodeficiency virus infection

Objective: To examine the construct of illness perception (IP) as measured by the Brief Illness Perception Questionnaire (BIPQ) using network analysis in patients with rheumatic diseases (RD) and with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS).Design: Cross-sectional and multicentre survey.Main Outcome Measures: The BIPQ and the Hospital Anxiety and Depression Scale.Results: BIPQ network structures did not differ between patients with RD and HIV/AIDS. Community analysis identified two clusters: one comprised consequences, timeline, identity, concern and emotional response; and the other consisted of personal control, treatment control and comprehensibility. Centrality indices indicate that concern, consequences and emotional response are central dimensions of the BIPQ. Directed acyclic graph analysis revealed that concern was a dominant network item, activating emotional response, consequences, identity and comprehensibility. Emotional response and consequences were bridging items linking IP to anxiety and depression.Conclusion: Perceived impact of illness on life and emotion and illness concern are central dimensions of the BIPQ that link IP to anxiety and depression in patients with RD and HIV/AIDS. Care of patients with RD and HIV/AIDS may benefit from addressing IP, particularly concern, emotional response and consequences to prevent clinical anxiety and depression.

The effectiveness of culturally tailored video narratives on medication understanding and use self-efficacy among stroke patients: A randomized controlled trial study protocol

INTRODUCTION

A substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy. Nevertheless, only a handful of studies have probed into the effectiveness of video narrative at stroke care centers.

METHOD

This is a behavioral randomized controlled trial of patient education intervention with video narratives for patients with stroke lacking medication understanding and use self-efficacy. The study will recruit up to 200 eligible stroke patients at the neurology tertiary outpatient clinic, whereby they will be requested to return for follow-up approximately 3 months once for up to 12 months. Consenting patients will be randomized to either standard patient education care or intervention with video narratives. The researchers will ensure control of potential confounding factors, as well as unbiased treatment review with prescribed medications only obtained onsite.

RESULTS

The primary analysis outcomes will reflect the variances in medication understanding and use self-efficacy scores, as well as the associated factors, such as retention of knowledge, belief and perception changes, whereas stroke risk factor control, for example, self-monitoring and quality of life, will be the secondary outcomes.

DISCUSSION AND CONCLUSION

The study should be able to determine if video narrative can induce a positive behavioral change towards stroke risk factor control via enhanced medication understanding and use self-efficacy. This intervention is innovative as it combines health belief, motivation, and role model concept to trigger self-efficacy in maintaining healthy behaviors and better disease management.

TRIAL REGISTRATION

ACTRN (12618000174280).