Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study

authors:

avatar Naima Seyed Fatemi , avatar Forough Rafii , avatar Ebrahim Hajizadeh , avatar Mahnaz Modanloo ORCID , *

Koomesh: Vol.20, issue 2; 179-191
published online: April 02, 2018
article type: Research Article
received: July 02, 2017
accepted: January 02, 2018

how to cite: Seyed Fatemi N, Rafii F, Hajizadeh E, Modanloo M. Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study. koomesh. 2018;20(2):e152948. 

Abstract

Introduction: Non-compliance is a concern to all healthcare disciplines especially in patients with chronic illness that is caused by social factors. For determining the factors affect on patients;#39 health, it is essentialto understand the meaning of compliance and its measurement which lead to improve compliance. However, there is not any instrument to assess compliance of all dimensions of treatment in patients with chronic disease in Iranian context. The purpose of this study was to develop and psychometric properties of compliance questionnaire. Materials and Methods: This study was conducted by triangulation approach in two concept analysis and methodological research sequential phases. In first part, Hybrid Model concept analysis was used to explore the meaning of compliance and to generate questionnaire items, and in second part psychometric properties was used to evaluate the validity and reliability of a compliance instrument.First, in theoretical phase of Hybrid Model concept analysis, data was collected by using literature reviews to develop a working definition. Second in field work phase qualitative data obtained through semi-structure interviews withparticipatingof 6 patients diagnosed with chronic disease. Third, in analytical phase, integration and reanalysis of the data gained during two former phases of concept analysis was conductedusing directed qualitative content analysis. In second part, a primary questionnaire was created by using the results of research. In the third part, the psychometric properties including face validity, content validity, construct validity, internal consistency, and test-retest reliability was measured. Results: The process of concept analysis in theoretical phase resulted in extracting 11 categories,in field work phase seven categories and in third phaseeight themes emerged.  127 items was extracted.The psychometric property was carried out as a result the 127-item questionnaire was modified and the items decreased to 48. The result of exploratory factor analysis showed that this questionnaire contains 7 factors including making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, commitment to treatment and indecisiveness for applying treatment and the items decreased to 40. The 7 factors explained nearly 48.514% of the variance of the questionnaire. The reliability was carried out by using test-retest reliability andCronbach;#39salpha 0.92. Conclusion: These findings offer helpful insights into the meaning of compliance and provide an instrument to assess the adherence of patients with chronic disease. The Adherence Questionnaire appears to be an appropriate tool for providing reliable and valid data to determine compliance in adult patients with chronic disease in Iranian context.

References

  • 1.

    Hashemdabaghian F, Karbakhsh M, Soheilikhah S, Sedaghat M. Drug Compliance in Patients with Type 2 Diabetes Mellitus in Shariati and Imam Khomeini Hospitals. Payesh 2005; 4: 103-11. [In Persian].

  • 2.

    Solaymani M. Participation of Patients with Chronic Illness in Nursing Care: Presentation of Model. Tehran Tehran University of Medical Sciences; 2010.

  • 3.

    Rafii F, Soleimani M, Seyedfatemi N. A model of patient participation with chronic disease in nursing care. Koomesh 2011; 12: 293-304 [In Persian].

  • 4.

    Eggenberger SK, Meiers SJ, Krumwiede N, Bliesmer M, Earle P. Reintegration within families in the context of chronic illness: a family health promoting process. J NursHealthc Chronic Illn2011; 3: 283-92.

  • 5.

    WHO. World Health Organization. Chronic diseases. (2013) Available at: http://www.who.int/topics/chronic_diseases/en/. Date of access: 13 January 2013.

  • 6.

    Cockerham WC, Hamby BW, Oates GR. The Social Determinants of Chronic Disease. Elsevier; 2017.

  • 7.

    WHO, editor. Political Declaration at the World Conference on Social Determinants of Health; October 1921, 2011; Rio de Janeiro, Brazil.

  • 8.

    World Health Organization. Chronic diseases. (2013) Available at: http://www.who.int/topics/chronic_diseases/en/. Date of access: 13 January 2013.

  • 9.

    World Health Organization. NCD Country Profiles (2011). Available at: http://www.who.int/nmh/countries/irn_en.pdf. Accessed 20 oct 2012.

  • 10.

    Hadi N, Rostami Gouran N, Jafari P. A study on the determining factors for compliance to prescribed medication by patients with high blood pressure. Scientific Medical Journal 2005; 4: 223-9. [In Persian].

  • 11.

    Yazdi-Ravandi S, Taslimi Z, Haghparast A, Ghaleiha A. Quality of life in patients with chronic pain disorders: determination the role of intensity and duration of pain. Koomesh 2016; 17: 836-43.

  • 12.

    Ebrahimi S, Zakerimoghadam M, Shahsavari H, Gholizadeh B, Naboureh A. Effects of self-management program and telephone follow up on medical adherence in patients with ischemic heart disease. Koomesh 2017; 19.

  • 13.

    Jin J, Sklar GE, Oh VMS, Li SC. Factors affecting therapeutic compliance: A review from the patients perspective. TherClin Risk Manag2008; 4: 269-86.

  • 14.

    Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther 2001; 26: 331-42.

  • 15.

    Bissonnette J. Adherence: a concept analysis. J AdvNurs2008; 63: 63443.

  • 16.

    Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. The Cochrane database of systematic reviews 2008; 2: CD000011.

  • 17.

    Kagee A, Le Roux M, Dick J. Treatment adherence among primary care patients in a historically disadvantaged community in South Africa: a qualitative study. J Health Psychol 2007; 12: 444-60.

  • 18.

    Patti F. Optimizing the benefit of multiple sclerosis therapy: the importance of treatment adherence. Patient Prefer Adherence2010 4: 19.

  • 19.

    Chatterjee JS. From compliance to concordance in diabetes. J Med Ethics2006; 32: 507-10.

  • 20.

    Hearnshaw H, Lindenmeyer A. What do we mean by adherence to treatment and advice for living with diabetes? A review of the literature on definitions and measurements. . Diabetic Medicine 2006; 23: 720-8.

  • 21.

    Kyngs HA, Kroll T, Duffy ME. Compliance in adolescents with chronic diseases: a review. Journal of Adolescent Health 2000; 26: 379-88.

  • 22.

    Bland RJ, Cottrell RR, Guyler LR. Medication Compliance of Hemodialysis Patients and Factors Contributing to Non-Compliance. Dialysis & Transplantation 2008; 37: 174-8.

  • 23.

    Van Hecke A, Grypdonck M, Defloor T. Interventions to enhance patient compliance with leg ulcer treatment: a review of the literature. J ClinNurs2008; 17: 2939.

  • 24.

    Fialko L, Garety PA, Kuipers E, Dunn G, Bebbington PE, Fowler D, Freeman D. A large-scale validation study of the Medication Adherence Rating Scale (MARS). Schizophrenia Research 2008; 100: 53-9.

  • 25.

    Zeller A, Schroeder K, Peters TJ. An adherence self-report questionnaire facilitated the differentiation between nonadherence and nonresponse to antihypertensive treatment. J Clin Epidemiol2008; 61: 282-8.

  • 26.

    Abbasi M, Salem iS, Seyed Fatemi N, Hosseini F. Hypertensive patients, their compliance level and its relation to their health beliefs Iranian Journal of Nursing Research(IJNR) 2005; 18: 61-8. [In Persian].

  • 27.

    Lahdenper TS, Kyngs HA. Levels of compliance shown by hypertensive patients and their attitude toward their illness. J AdvNurs2001; 34: 189-95.

  • 28.

    Duncan C, Cloutier JD, Bailey PH. Concept analysis: the importance of differentiating the ontological focus. Journal of Advanced Nursing 2007; 58: 293300.

  • 29.

    Elo S, Kyngas H. The qualitative Content Analysis process J AdvNurs2008; 62: 107-15.

  • 30.

    Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today2004; 24: 105-12.

  • 31.

    Rodgers BL, Knafl KA. Concept development in nursing: foundation, techniques, and application. 2nd ed. Philadelphia: W.B.Saunders Company; 2000.

  • 32.

    LoBiondo-Wood G, Haber J, editors. Nursing research. 6th ed: Mosby Elsevier; 2006.

  • 33.

    Asadi-Lari M, Packham C, Gray D. Psychometric properties of a new health needs analysis tool designed for cardiac patients. Public health 2005; 119: 590-8.

  • 34.

    Maasoumi R, Lamyian M, Montazeri A, Azin SA, Aguilar-Vafaie ME, Hajizadeh E. The sexual quality of life-female (SQOL-F) questionnaire: translation and psychometric properties of the Iranian version. Reproductive health 2013; 10: 25-31.

  • 35.

    Polite D, Beck C, editors. NURSING RESEARCH: Generating and Assessing Evidence for Nursing Practice. 8th ed. Philadelphia: Lippincott Williams & Wilkins. ; 2008.

  • 36.

    Wallace LS, Blake GH, Parham JS, Baldridge RE. Development and Content Validation of Family Practice Residency Recruitment Questionnaires. Family Medicine 2003; 35: 496-8.

  • 37.

    Playle JF, Keeley P. Non-compliance and professional power. J AdvNurs 1998; 27: 304-11.

  • 38.

    Wetzels G, Nelemans P, van Wijk B, Broers N, Schouten J, Prins M. Determinants of poor adherence in hypertensive patients: Development and validation of the "Maastricht Utrecht Adherence in Hypertension (MUAH)-questionnaire". Patient EducCouns 2006; 64: 151-8.

  • 39.

    Lahdenper TS, Wright CC, Kyngs HA. Development of a scale to assess the compliance of hypertensive patients. Int J Nurs Stud2003; 40: 677-84.

  • 40.

    Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. J Clin Epidemiol 2010; 63: 299-306.

  • 41.

    Ogedegbe G, Mancuso CA, Allegrante JP, Charlson ME. Development and evaluation of a medication adherence self-efficacy scale in hypertensive African-American patients. J Clin Epidemiol2003; 56: 520-9.

  • 42.

    Resnick B, Wehren L, Orwig D. Reliability and validity of the self-efficacy and outcome expectations for osteoporosis medication adherence scales. Orthopaedic Nursing 2003; 22: 139-47.

  • 43.

    Rushe H, Mcgee HM. Assessing adherence to dietary recommendations for hemodialysis patients: the Renal Adherence Attitudes Questionnaire (RAAQ) and the Renal Adherence Behaviour Questionnaire (RABQ). Journal of psychosomatic research 1998; 45: 149-57.

  • 44.

    Holstad MM, Foster V, DiIorio C, McCarty F, Teplinskiy I. An Examination of the Psychometric Properties of the Antiretroviral General Adherence Scale (AGAS) in Two Samples of HIV-Infected Individuals. JANAC 2010; 21: 162-72.

  • 45.

    McPherson-Baker S, Jones D, Durn RE, Klimas N, Schneiderman N. Development and Implementation of a Medication Adherence Training Instrument for Persons Living With HIV The MATI. Behavior modification 2005; 29: 286-317.

  • 46.

    Kyngs HA, Skaar-Chandler CA, Duffy ME. The development of an instrument to measure the compliance of adolescents with a chronic disease. J Adv Nurs 2000; 32: 1499-506.

  • 47.

    Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence. . Medical Care 1986; 24: 67-74.

  • 48.

    Jank S, Bertsche T, Schellberg D, Herzog W, Haefeli WE. The A14-scale: development and evaluation of a questionnaire for assessment of adherence and individual barriers. Pharm World Sci 2009; 31: 426-31.##.