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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Development of the “Treatment beliefs in knee and hip OsteoArthritis (TOA)” questionnaire

Authors: Ellen M. H. Selten, Johanna E. Vriezekolk, Henk J. Schers, Marc W. Nijhof, Willemijn H. van der Laan, Roelien G. van der Meulen-Dilling, Rinie Geenen, Cornelia H. M. van den Ende

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Use of conservative treatment modalities in osteoarthritis (OA) is suboptimal, which appears to be partly due to patients’ beliefs about treatments. The aim of this study was to develop a research instrument assessing patients’ beliefs about various treatment modalities of hip and knee OA: the ‘Treatment beliefs in OA (TOA) questionnaire’.

Methods

The item pool that was retrieved from interviews with patients and healthcare providers comprised beliefs regarding five treatment modalities: physical activity, pain medication, physiotherapy, injections and arthroplasty. After an extensive selection procedure, a draft questionnaire with 200 items was constructed. Descriptive analyses and exploratory factor analyses with oblique rotation were conducted for each treatment modality separately to decide upon the final questionnaire. Internal consistency and test-retest reliability were determined.

Results

The final questionnaire comprised 60 items. It was completed by 351 patients with knee or hip OA. Each of the five treatment modalities yielded a two factor solution with 37% to 51% explained variance and high face validity. Factor I included ‘positive treatment beliefs’ and factor II ‘negative treatment beliefs’. Internal consistency (Cronbach α’s from 0.72 to 0.87) and test-retest reliability (i.e. intraclass correlation coefficient from 0.66–0.88; standard error of measurement from 0.06–0.11) were satisfactory to good.

Conclusions

The TOA questionnaire is the first questionnaire assessing positive and negative treatment beliefs regarding five treatment modalities for knee and hip OA. The instrument will help to understand whether and to what extent treatment beliefs influence treatment choices.
Appendix
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Literature
1.
Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377:2115–26.CrossRefPubMed
2.
McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil. 2014;22:363–88.CrossRefPubMed
3.
Smink AJ, van den Ende CH, Vliet Vlieland TP, Swierstra BA, Kortland JH, Bijlsma JW, et al. "Beating osteoARThritis": development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis. Clin Rheumatol. 2011;30:1623–9.CrossRefPubMed
4.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil. 2008;16:137–62.CrossRefPubMed
5.
McHugh GA, Luker KA, Campbell M, Kay PR, Silman AJ. A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rheumatology (Oxford). 2007;46:631–7.CrossRef
6.
Shrier I, Feldman DE, Gaudet MC, Rossignol M, Zukor D, Tanzer M, et al. Conservative non-pharmacological treatment options are not frequently used in the management of hip osteoarthritis. J Sci Med Sport. 2006;9:81–6.CrossRefPubMed
7.
Snijders GF, den Broeder AA, van Riel PL, Straten VH, de Man FH, van den Hoogen FH, et al. Evidence-based tailored conservative treatment of knee and hip osteoarthritis: between knowing and doing. Scand J Rheumatol. 2011;40:225–31.CrossRefPubMed
8.
Otten R, van Roermund PM. Picavet HS: [Trends in the number of knee and hip arthroplasties: considerably more knee and hip prostheses due to osteoarthritis in 2030]. Ned Tijdschr Geneeskd. 2010;154:A1534.PubMed
9.
Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2:e000435.CrossRefPubMedPubMedCentral
10.
Nilsdotter AK, Toksvig-Larsen S, Roos EM. Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop. 2009;80:55–61.CrossRefPubMedPubMedCentral
11.
Hofstede SN, Marang-van de Mheen PJ, Vliet Vlieland TP, van den Ende CH, Nelissen RG, van Bodegom-Vos L. Barriers and Facilitators Associated with Non-Surgical Treatment Use for Osteoarthritis Patients in Orthopaedic Practice. PLoS One. 2016;11:e0147406.CrossRefPubMedPubMedCentral
12.
Tariman JD, Doorenbos A, Schepp KG, Becker PS, Berry DL. Patient, Physician and Contextual Factors Are Influential in the Treatment Decision Making of Older Adults Newly Diagnosed with Symptomatic Myeloma. Cancer Treat Commun. 2014;2:34–47.CrossRefPubMedPubMedCentral
13.
Ajzen I. The Theory of Planned Behavior. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef
14.
Uebelacker LA, Bailey G, Herman D, Anderson B, Stein M. Patients' Beliefs About Medications are Associated with Stated Preference for Methadone, Buprenorphine, Naltrexone, or no Medication-Assisted Therapy Following Inpatient Opioid Detoxification. J Subst Abus Treat. 2016;66:48–53.CrossRef
15.
Francis JJ, Wileman SM, Bekker H, Barton GR, Ramsay CR. Beliefs about surgery: Development and validation of an instrument to assess cognitive representations about surgery, in the context of a chronic illness. Psychol Health. 2009;24:1125–37.CrossRefPubMed
16.
17.
Selten EM, Vriezekolk JE, Geenen R, van der Laan WH, van der Meulen-Dilling RG, Nijhof MW, et al. Reasons for Treatment Choices in Knee and Hip Osteoarthritis: A Qualitative Study. Arthritis Care Res (Hoboken ). 2016;68:1260–7.CrossRef
18.
Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan PG. Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography. Rheumatol Int. 2014;34:299–313.CrossRefPubMed
19.
Benhamou M, Baron G, Dalichampt M, Boutron I, Alami S, Rannou F, et al. Development and validation of a questionnaire assessing fears and beliefs of patients with knee osteoarthritis: the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ). PLoS One. 2013;8:e53886.CrossRefPubMedPubMedCentral
20.
Benhamou M, Boutron I, Dalichampt M, Baron G, Alami S, Rannou F, et al. Elaboration and validation of a questionnaire assessing patient expectations about management of knee osteoarthritis by their physicians: the Knee Osteoarthritis Expectations Questionnaire. Ann Rheum Dis. 2013;72:552–9.CrossRefPubMed
21.
Dima A, Lewith GT, Little P, Moss-Morris R, Foster NE, Hankins M, et al. Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care. Pain. 2015;156:1489–500.CrossRefPubMed
22.
Horne R, Weinman J, Hankins M. The Beliefs about Medicines Questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;4:1–24.CrossRef
23.
Selten EMH, Vriezekolk JE, Nijhof MW, Schers HJ, Van der Meulen-Dilling RG, van der Laan WH et al. Barriers impeding the use of non-pharmacological, non-surgical care in hip and knee osteoarthritis: the views of general practitioners, physiotherapists and medical specialists. Journal of Clinical Rheumatology. 2017; in press.
24.
Selten EM, Geenen R, van der Laan WH, van der Meulen-Dilling RG, Schers HJ, Nijhof MW, et al. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study. Rheumatology (Oxford). 2017;56:271–8.CrossRef
25.
Streiner DL, Norman GR. Health Measurement Scales, a practical guide to their development and use. 4th ed. New York: Oxford University Press; 2008.CrossRef
26.
De Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in Medicine. 1st ed. New York: Cambridge University Press; 2011.CrossRef
27.
Willis GB, Artino AR Jr. What Do Our Respondents Think We're Asking? Using Cognitive Interviewing to Improve Medical Education Surveys. J Grad Med Educ. 2013;5:353–6.CrossRefPubMedPubMedCentral
28.
Riemsma RP, Taal E, Rasker JJ, Houtman PM, VAn Paassen HC, Wiegman O. Evaluation of a Dutch version of the AIMS2 for patients with rheumatoid arthritis. Br J Rheumatol. 1996;35:755–60.CrossRefPubMed
29.
Bellamy N. The WOMAC Knee and Hip Osteoarthritis Indices: development, validation, globalization and influence on the development of the AUSCAN Hand Osteoarthritis Indices. Clin Exp Rheumatol. 2005;23:S148–53.PubMed
30.
Costello AB, Osborne JW. Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis. Pract Assess Res Eval. 2005;10
31.
Tabachnick BG, Fidell LS. Using Multivariate Statistics. 5th ed. Boston: Allyn and Bacon; 2007.
32.
Rankin G, Stokes M. Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses. Clin Rehabil. 1998;12:187–99.CrossRefPubMed
33.
Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420–8.CrossRefPubMed
34.
Terwee CB, Mokkink LB, Steultjens MP, Dekker J. Performance-based methods for measuring the physical function of patients with osteoarthritis of the hip or knee: a systematic review of measurement properties. Rheumatology (Oxford). 2006;45:890–902.CrossRef
35.
Hawker GA. Who, when, and why total joint replacement surgery? The patient's perspective. Curr Opin Rheumatol. 2006;18:526–30.PubMed
36.
Ratcliffe J, Buxton M, McGarry T, Sheldon R, Chancellor J. Patients' preferences for characteristics associated with treatments for osteoarthritis. Rheumatology (Oxford). 2004;43:337–45.CrossRef
37.
Allen KD, Bosworth HB, Chatterjee R, Coffman CJ, Corsino L, Jeffreys AS, et al. Clinic variation in recruitment metrics, patient characteristics and treatment use in a randomized clinical trial of osteoarthritis management. BMC Musculoskelet Disord. 2014;15:413.CrossRefPubMedPubMedCentral
38.
Jordan KP, Tan V, Edwards JJ, Chen Y, Englund M, Hubertsson J, et al. Influences on the decision to use an osteoarthritis diagnosis in primary care: a cohort study with linked survey and electronic health record data. Osteoarthr Cartil. 2016;24:786–93.CrossRefPubMedPubMedCentral
39.
Musila N, Underwood M, McCaskie AW, Black N, Clarke A, van der Meulen JH. Referral recommendations for osteoarthritis of the knee incorporating patients' preferences. Fam Pract. 2011;28:68–74.CrossRefPubMed
40.
Berger MJ, Kean CO, Goela A, Doherty TJ. Disease severity and knee extensor force in knee osteoarthritis: data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2012;64:729–34.CrossRef
41.
Gronhaug G, Osteras N, Hagen KB. Quality of hip and knee osteoarthritis management in primary health care in a Norwegian county: a cross-sectional survey. BMC Health Serv Res. 2014;14:598.CrossRefPubMedPubMedCentral
Metadata
Title
Development of the “Treatment beliefs in knee and hip OsteoArthritis (TOA)” questionnaire
Authors
Ellen M. H. Selten
Johanna E. Vriezekolk
Henk J. Schers
Marc W. Nijhof
Willemijn H. van der Laan
Roelien G. van der Meulen-Dilling
Rinie Geenen
Cornelia H. M. van den Ende
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1762-3

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