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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

The factor structure of the Turkish version of the Revised Illness Perception Questionnaire (IPQ-R) in patients with diabetes and cardiovascular disease

Authors: Patrick Brzoska, Yüce Yilmaz-Aslan, Eda Sultanoglu, Bülent Sultanoglu, Oliver Razum

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

The Revised Illness Perception Questionnaire (IPQ-R) has been used extensively in the study of illness perceptions across different populations. Only few confirmatory factor analytic (CFA) studies of the questionnaire are available. This study examines the construct and discriminant validity of the Turkish IPQ-R in patients with diabetes and cardiovascular disease focusing on the hypothesized seven dimensions of personal controllability, treatment controllability, timeline acute/chronic, timeline cyclical, coherence, consequences and emotional representations.

Methods

302 patients (60.6% women) with a medically confirmed diagnosis of diabetes or cardiovascular disease and a mean age of 53.9 years were recruited from out-patient clinics in Turkey and surveyed by means of standardized interviews. Direct maximum likelihood confirmatory factor analysis was conducted.

Results

Several areas of ill-fit were identified in the original measurement model of the IPQ-R. Four items (items 17, 19, 20, and 31) were deleted because of poor factor loadings. Also, two error covariances (between items 33 and 34 and between items 7 and 8) were added and item 6 respecified to obtain a good model fit. The modified 34-item model showed good reliability and discriminant validity.

Conclusion

In accordance with studies on other language adaptations of the questionnaire, we identified certain items of the IPQ-R as potential sources of poor model fit. Their inclusion should be reconsidered in future applications of the questionnaire and researchers should examine whether our reduced set of items is stable across different populations. Our modified 34-item model showed a good reliability and discriminant validity and hence could be a valuable instrument in the assessment of illness perceptions in the Turkish health care setting, provided that the model is confirmed in subsequent research.
Literature
1.
go back to reference Lubkin IM, Larsen PD: What is chronicity?. Chronic illness: Impact and interventions. Edited by: Lubkin IM, Larsen PD. 2005, Sudbury: Jones and Bartlett, 1-24. Lubkin IM, Larsen PD: What is chronicity?. Chronic illness: Impact and interventions. Edited by: Lubkin IM, Larsen PD. 2005, Sudbury: Jones and Bartlett, 1-24.
2.
go back to reference Leventhal H, Meyer D, Nerenez D: The common sense representation of illness danger. Contributions to medical psychology. Edited by: Rachman S. 1980, Oxford: Pergamon Press, 7-30. Leventhal H, Meyer D, Nerenez D: The common sense representation of illness danger. Contributions to medical psychology. Edited by: Rachman S. 1980, Oxford: Pergamon Press, 7-30.
3.
go back to reference Leventhal H, Brisette L, Leventhal EA: The common-sense model of self-regulation of health and illness. The self-regulation of health and illness behaviour. Edited by: Cameron LD, Leventhal H. 2003, New York: Routledge, 42-65. Leventhal H, Brisette L, Leventhal EA: The common-sense model of self-regulation of health and illness. The self-regulation of health and illness behaviour. Edited by: Cameron LD, Leventhal H. 2003, New York: Routledge, 42-65.
4.
go back to reference Hagger MS, Orbell S: A meta-analytic review of the common-sense model of illness representations. Psych Health. 2003, 18: 141-184. 10.1080/088704403100081321.CrossRef Hagger MS, Orbell S: A meta-analytic review of the common-sense model of illness representations. Psych Health. 2003, 18: 141-184. 10.1080/088704403100081321.CrossRef
5.
go back to reference Broadbent E, Ellis C, Thomas J, Gamble G, Petrie KJ: Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res. 2009, 67: 17-23. 10.1016/j.jpsychores.2008.12.001.CrossRefPubMed Broadbent E, Ellis C, Thomas J, Gamble G, Petrie KJ: Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res. 2009, 67: 17-23. 10.1016/j.jpsychores.2008.12.001.CrossRefPubMed
6.
go back to reference Scharloo M, Kaptein AA: Measurement of illness perception in patients with chronic somatic illness: A review. Perception of health and illness. Edited by: Petrie KJ, Weinman J. 1997, Amsterdam: Harwood, 103-154. Scharloo M, Kaptein AA: Measurement of illness perception in patients with chronic somatic illness: A review. Perception of health and illness. Edited by: Petrie KJ, Weinman J. 1997, Amsterdam: Harwood, 103-154.
7.
go back to reference Weinman J, Petrie KJ, Moss-Morris R, Horne R: The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psych Health. 1996, 11: 431-445. 10.1080/08870449608400270.CrossRef Weinman J, Petrie KJ, Moss-Morris R, Horne R: The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psych Health. 1996, 11: 431-445. 10.1080/08870449608400270.CrossRef
8.
go back to reference Moss-Morris R, Weinman I, Petrie KJ, Horne R, Cameron LD, Buick D: The revised illness perception questionnaire (IPQ-R). Psych Health. 2002, 17: 1-16. 10.1080/08870440290001494.CrossRef Moss-Morris R, Weinman I, Petrie KJ, Horne R, Cameron LD, Buick D: The revised illness perception questionnaire (IPQ-R). Psych Health. 2002, 17: 1-16. 10.1080/08870440290001494.CrossRef
9.
go back to reference Kocaman N, Özkan M, Armay Z, Özkan S: Hastalik Algisi Ölçeginin Türkçe uyarlamasinin geçerlilik ve güvenilirlik çalismasi [Reliability and validity study of the Turkish adaptation of the revised Illness Perception Questionnaire]. Anadolu Psikiyatri Dergisi. 2007, 8: 271-280. Kocaman N, Özkan M, Armay Z, Özkan S: Hastalik Algisi Ölçeginin Türkçe uyarlamasinin geçerlilik ve güvenilirlik çalismasi [Reliability and validity study of the Turkish adaptation of the revised Illness Perception Questionnaire]. Anadolu Psikiyatri Dergisi. 2007, 8: 271-280.
10.
go back to reference Brown T: Confirmatory factor analysis for applied research. 2006, New York: Guilford Brown T: Confirmatory factor analysis for applied research. 2006, New York: Guilford
11.
go back to reference Dempster M, McCorry NK: The factor structure of the revised illness perception questionnaire in a population of oesophageal cancer survivors. Psychooncology. 2012, 21: 524-530. 10.1002/pon.1927.CrossRefPubMed Dempster M, McCorry NK: The factor structure of the revised illness perception questionnaire in a population of oesophageal cancer survivors. Psychooncology. 2012, 21: 524-530. 10.1002/pon.1927.CrossRefPubMed
12.
go back to reference Hagger MS, Orbell S: A confirmatory factor analysis of the revised illness perception questionnaire (IPQ-R) in a cervical screening context. Psych Health. 2005, 20: 161-173. 10.1080/0887044042000334724.CrossRef Hagger MS, Orbell S: A confirmatory factor analysis of the revised illness perception questionnaire (IPQ-R) in a cervical screening context. Psych Health. 2005, 20: 161-173. 10.1080/0887044042000334724.CrossRef
13.
go back to reference Wittkowski A, Richards HL, Williams J, Main CJ: Factor analysis of the revised illness perception questionnaire in adults with atopic dermatitis. Psychol Health Med. 2008, 13: 346-359. 10.1080/13548500701487697.CrossRefPubMed Wittkowski A, Richards HL, Williams J, Main CJ: Factor analysis of the revised illness perception questionnaire in adults with atopic dermatitis. Psychol Health Med. 2008, 13: 346-359. 10.1080/13548500701487697.CrossRefPubMed
14.
go back to reference Abubakari AR, Joney MC, Lauder W, Kirk A, Devendra D, Anderson J: Psychometric properties of the revised illness perception questionnaire: factor structure and reliability among African-origin populations with type 2 diabetes. Int J Nurs Stud. 2012, 49: 672-681. 10.1016/j.ijnurstu.2011.11.008.CrossRefPubMed Abubakari AR, Joney MC, Lauder W, Kirk A, Devendra D, Anderson J: Psychometric properties of the revised illness perception questionnaire: factor structure and reliability among African-origin populations with type 2 diabetes. Int J Nurs Stud. 2012, 49: 672-681. 10.1016/j.ijnurstu.2011.11.008.CrossRefPubMed
15.
go back to reference Chilcot J, Norton S, Wellsted D, Farrington K: The factor structure of the revised illness perception questionnaire (IPQ-R) in end-stage renal disease patients. Psychol Health Med. 2012, 17: 578-588. 10.1080/13548506.2011.647702.CrossRefPubMed Chilcot J, Norton S, Wellsted D, Farrington K: The factor structure of the revised illness perception questionnaire (IPQ-R) in end-stage renal disease patients. Psychol Health Med. 2012, 17: 578-588. 10.1080/13548506.2011.647702.CrossRefPubMed
16.
go back to reference Nicholls EE, Hill S, Foster NE: Musculoskeletal pain illness perceptions: Factor structure of the Illness Perceptions Questionnaire-Revised. Psych Health. 2012,  :  -[Epub ahead of print] Nicholls EE, Hill S, Foster NE: Musculoskeletal pain illness perceptions: Factor structure of the Illness Perceptions Questionnaire-Revised. Psych Health. 2012,  :  -[Epub ahead of print]
17.
go back to reference Chen SL, Tsai JC, Lee WL: Psychometric validation of the Chinese version of the illness perception questionnaire-revised for patients with hypertension. J Adv Nurs. 2008, 64: 524-534. 10.1111/j.1365-2648.2008.04808.x.CrossRefPubMed Chen SL, Tsai JC, Lee WL: Psychometric validation of the Chinese version of the illness perception questionnaire-revised for patients with hypertension. J Adv Nurs. 2008, 64: 524-534. 10.1111/j.1365-2648.2008.04808.x.CrossRefPubMed
18.
go back to reference Brink E, Alsén P, Cliffordson C: Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction – the Swedish version. Scand J Psychol. 2011, 52: 573-579. 10.1111/j.1467-9450.2011.00901.x.CrossRefPubMed Brink E, Alsén P, Cliffordson C: Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction – the Swedish version. Scand J Psychol. 2011, 52: 573-579. 10.1111/j.1467-9450.2011.00901.x.CrossRefPubMed
19.
go back to reference Cabassa LJ, Lagomasino IT, Dwight-Johnson M, Hansen MC, Xie B: Measuring Latinos’ perceptions of depression: a confirmatory factor analysis of the illness perception questionnaire. Cultur Divers Ethnic Minor Psychol. 2008, 14: 377-384.CrossRefPubMedPubMedCentral Cabassa LJ, Lagomasino IT, Dwight-Johnson M, Hansen MC, Xie B: Measuring Latinos’ perceptions of depression: a confirmatory factor analysis of the illness perception questionnaire. Cultur Divers Ethnic Minor Psychol. 2008, 14: 377-384.CrossRefPubMedPubMedCentral
20.
go back to reference Armay Z, Özkan M, Kocaman N, Özkan S: Hastalik Algisi Ölçegi’nin Kanser Hastalarinda Türkçe Geçerlik ve Güvenirlik Çalismasi [The reliability and validity of the Illness Perception Questionnaire in cancer patients]. Klinik Psikiyatri Dergisi. 2007, 10: 192-200. Armay Z, Özkan M, Kocaman N, Özkan S: Hastalik Algisi Ölçegi’nin Kanser Hastalarinda Türkçe Geçerlik ve Güvenirlik Çalismasi [The reliability and validity of the Illness Perception Questionnaire in cancer patients]. Klinik Psikiyatri Dergisi. 2007, 10: 192-200.
21.
go back to reference Marsh HW, Hau KT, Balla JR, Grayson D: Is more ever too much? The number of indicators per factor in confirmatory factor analysis. Multivar Behav Res. 1998, 33: 181-220. 10.1207/s15327906mbr3302_1.CrossRef Marsh HW, Hau KT, Balla JR, Grayson D: Is more ever too much? The number of indicators per factor in confirmatory factor analysis. Multivar Behav Res. 1998, 33: 181-220. 10.1207/s15327906mbr3302_1.CrossRef
22.
go back to reference Muthén LK, Muthén BO: How to use a Monte Carlo study to decide on sample size and determine power. Struct Equ Model. 2002, 9: 599-620. 10.1207/S15328007SEM0904_8.CrossRef Muthén LK, Muthén BO: How to use a Monte Carlo study to decide on sample size and determine power. Struct Equ Model. 2002, 9: 599-620. 10.1207/S15328007SEM0904_8.CrossRef
23.
go back to reference Muthén LK, Muthén BO: Mplus User’s Guide. 2007, Los Angeles: Muthén & Muthén, 5 Muthén LK, Muthén BO: Mplus User’s Guide. 2007, Los Angeles: Muthén & Muthén, 5
24.
go back to reference Kline RB: Principles and practice of structural equation modeling. 2005, New York: Guilford Press Kline RB: Principles and practice of structural equation modeling. 2005, New York: Guilford Press
25.
go back to reference Bagozzi RP, Yi Y: On the evaluation of structural equation models. J Acad Market Sci. 1988, 16: 74-94. 10.1007/BF02723327.CrossRef Bagozzi RP, Yi Y: On the evaluation of structural equation models. J Acad Market Sci. 1988, 16: 74-94. 10.1007/BF02723327.CrossRef
26.
go back to reference Netemeyer RG, Bearden WO, Sharma S: Scaling procedures. Issues and applications. 2003, Thousand Oaks: SageCrossRef Netemeyer RG, Bearden WO, Sharma S: Scaling procedures. Issues and applications. 2003, Thousand Oaks: SageCrossRef
28.
go back to reference Önder SW: We have no microbes here: Healing practices in a Turkish Black Sea village. 2007, Durkham: Carolina Academic Press Önder SW: We have no microbes here: Healing practices in a Turkish Black Sea village. 2007, Durkham: Carolina Academic Press
29.
go back to reference Jackson DL: Sample size and number of parameter estimates in maximum likelihood confirmatory factor analysis: A Monte Carlo investigation. Struct Equ Model. 2001, 8: 205-223. 10.1207/S15328007SEM0802_3.CrossRef Jackson DL: Sample size and number of parameter estimates in maximum likelihood confirmatory factor analysis: A Monte Carlo investigation. Struct Equ Model. 2001, 8: 205-223. 10.1207/S15328007SEM0802_3.CrossRef
30.
go back to reference Ericsson KA, Simon H: Protocol analysis: Verbal reports as data. 1993, Cambridge: MIT Press Ericsson KA, Simon H: Protocol analysis: Verbal reports as data. 1993, Cambridge: MIT Press
31.
go back to reference van Oort L, Schröder C, French DP: What do people think about when they answer the Brief Illness Perception Questionnaire? A ‘think-aloud’ study. Br J Health Psychol. 2011, 16: 231-245. 10.1348/135910710X500819.CrossRefPubMed van Oort L, Schröder C, French DP: What do people think about when they answer the Brief Illness Perception Questionnaire? A ‘think-aloud’ study. Br J Health Psychol. 2011, 16: 231-245. 10.1348/135910710X500819.CrossRefPubMed
32.
go back to reference Bäärnhielm S, Ekblad S: Turkish migrant women encountering health care in Stockholm: a qualitative study of somatization and illness meaning. Cult Med Psychiatry. 2000, 24: 431-452. 10.1023/A:1005671732703.CrossRefPubMed Bäärnhielm S, Ekblad S: Turkish migrant women encountering health care in Stockholm: a qualitative study of somatization and illness meaning. Cult Med Psychiatry. 2000, 24: 431-452. 10.1023/A:1005671732703.CrossRefPubMed
33.
go back to reference Brzoska P, Voigtländer S, Spallek J, Razum O: Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. Eur J Epidemiol. 2010, 25: 651-660. 10.1007/s10654-010-9468-y.CrossRefPubMed Brzoska P, Voigtländer S, Spallek J, Razum O: Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. Eur J Epidemiol. 2010, 25: 651-660. 10.1007/s10654-010-9468-y.CrossRefPubMed
34.
go back to reference Brzoska P, Razum O: Validity issues in quantitative migrant health research. The example of illness perceptions. 2010, Frankfurt am Main: Peter Lang Brzoska P, Razum O: Validity issues in quantitative migrant health research. The example of illness perceptions. 2010, Frankfurt am Main: Peter Lang
Metadata
Title
The factor structure of the Turkish version of the Revised Illness Perception Questionnaire (IPQ-R) in patients with diabetes and cardiovascular disease
Authors
Patrick Brzoska
Yüce Yilmaz-Aslan
Eda Sultanoglu
Bülent Sultanoglu
Oliver Razum
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-852

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