Quality of Life Research

, Volume 22, Issue 6, pp 1391–1403 | Cite as

Assessment of proximal outcomes of self-management programs: translation and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQ™)

  • Michael SchulerEmail author
  • Gunda Musekamp
  • Hermann Faller
  • Inge Ehlebracht-König
  • Christoph Gutenbrunner
  • Roland Kirchhof
  • Jürgen Bengel
  • Sandra Nolte
  • Richard H. Osborne
  • Monika Schwarze



This paper describes the translation, cultural adaption, and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQ™), a widely used generic instrument assessing a wide range of proximal outcomes of self-management programs.


The translation was carried out according to international standards and included forward and backward translations. Comprehensibility and content validity were tested using cognitive interviews with 10 rehabilitation inpatients. Psychometric properties were examined in rehabilitation inpatients (n = 1,202) with a range of chronic conditions. Factorial validity was assessed using confirmatory factor analysis; concurrent validity was explored by correlations with comparator scales.


The items of the German heiQ™ were well understood by rehabilitation inpatients. The structure of the eight heiQ™ scales was replicated after minor adjustment. heiQ™ scales had higher correlations with comparator scales with similar constructs, particularly mental health concepts than with physical health. Moreover, all heiQ™ scales differentiated between individuals across different levels of depression.


The German heiQ™ is comprehensible for German-speaking patients suffering from different types of chronic conditions; it assesses relevant outcomes of self-management programs in a reliable and valid manner. Further studies involving its practical application are warranted.


Self-management Assessment Chronic disease Translation Validation 



The authors wish to thank our cooperation clinics: Rehabilitation Center Bad Eilsen, Hospital Bad Bramstedt, Hospital Bad Oexen, Hospital Bad Reichenhall, Hospital Norderney, Deegenberg Hospital Bad Kissingen, and Rehabilitation Center Bad Mergentheim Hospital Taubertal. We also wish to thank Matthias Lukasczik, Silke Neuderth, Katja Spanier, Christoph Egen, Ann Kathrin Skirde, Melanie Hawkins, and Gerald Elsworth. This project was funded by the German Federal Ministry of Education and Research (Bundesministerium fuer Bildung und Forschung). Professor Osborne was supported in part by an Australian National Health and Medical Research Council Population Health Career Development Award (#400391).

Conflict of interest

The authors state that there are no conflicts of interests.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Michael Schuler
    • 1
    Email author
  • Gunda Musekamp
    • 1
  • Hermann Faller
    • 1
  • Inge Ehlebracht-König
    • 2
  • Christoph Gutenbrunner
    • 3
  • Roland Kirchhof
    • 3
  • Jürgen Bengel
    • 4
  • Sandra Nolte
    • 5
    • 6
  • Richard H. Osborne
    • 5
  • Monika Schwarze
    • 3
  1. 1.Department of Psychotherapy and Medical Psychology, Rehabilitation Sciences SectionUniversity of WuerzburgWuerzburgGermany
  2. 2.Rehabilitation Center Bad EilsenBad EilsenGermany
  3. 3.Coordination Centre Applied Rehabilitation Research, Department of Rehabilitation MedicineMedical School HannoverHannoverGermany
  4. 4.Department of PsychologyUniversity of FreiburgFreiburgGermany
  5. 5.School of Health and Social DevelopmentDeakin UniversityMelbourneAustralia
  6. 6.Medical Clinic for Psychosomatics CharitéUniversity Medicine BerlinBerlinGermany

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