Assessment of proximal outcomes of self-management programs: translation and psychometric evaluation of a German version of the Health Education Impact Questionnaire (heiQ™)
- 1.1k Downloads
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.
KeywordsSelf-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.
- 2.Osborne, R. H., Batterham, R., & Livingston, J. (2011). The evaluation of chronic disease self-management support across settings: The international experience of the health education impact questionnaire quality monitoring system. The Nursing clinics of North America, 46(3), 255–270.PubMedCrossRefGoogle Scholar
- 4.Hobbs, F. D., Kenkre, J. E., Roalfe, A. K., Davis, R. C., Hare, R., & Davies, M. K. (2002). Impact of heart failure and left ventricular systolic dysfunction on quality of life: A cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population. European Heart Journal, 23(23), 1867–1876.PubMedCrossRefGoogle Scholar
- 5.Faller, H., Stork, S., Schuler, M., Schowalter, M., Steinbuechel, T., Ertl, G., et al. (2009). Depression and disease severity as predictors of health-related quality of life in patients with chronic heart failure—A structural equation modeling approach. Journal of Cardiac Failure, 15(4), 286–292.Google Scholar
- 11.Ditewig, J. B., Blok, H., Havers, J., & van Veenendaal, H. (2010). Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: A systematic review. Patient Education and Counseling, 78(3), 297–315.PubMedCrossRefGoogle Scholar
- 12.Cockle-Hearne, J., & Faithfull, S. (2010). Self-management for men surviving prostate cancer: A review of behavioural and psychosocial interventions to understand what strategies can work, for whom and in what circumstances. Psycho-Oncology, 19, 909–922.Google Scholar
- 14.Deakin, T. A., McShane, C. E., Cade, J. E., & Williams, R. (2005). Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, (2), CD003417.Google Scholar
- 15.Foster, G., Taylor, S. J. C., Eldridge, S. E., Ramsay, J., & Griffiths, C. J. (2007). Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database of Systematic Reviews, (4), CD005108.Google Scholar
- 20.Meng, K., Seekatz, B., Roband, H., Worringen, U., Vogel, H., & Faller, H. (2011). Intermediate and long-term effects of a standardized back school for inpatient orthopedic rehabilitation on illness knowledge and self-management behaviors: A randomized controlled trial. The Clinical Journal of Pain, 27(3), 248–257.PubMedCrossRefGoogle Scholar
- 21.Crotty, M., Prendergast, J., Battersby, M. W., Rowett, D., Graves, S. E., Leach, G., et al. (2009). Self-management and peer support among people with arthritis on a hospital joint replacement waiting list: A randomised controlled trial. Osteoarthritis and Cartilage, 17(11), 1428–1433.PubMedCrossRefGoogle Scholar
- 22.Osborne, R. H., Elsworth, G. R., & Whitfield, K. (2007). The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Education and Counseling, 66(2), 192–201.PubMedCrossRefGoogle Scholar
- 23.Francis, K. L., Matthews, B. L., Van Mechelen, W., Bennell, K. L., & Osborne, R. H. (2009). Effectiveness of a community-based osteoporosis education and self-management course: A wait list controlled trial. Osteoporosis International: A Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 20(9), 1563–1570.CrossRefGoogle Scholar
- 25.Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., Erikson, P., & ISPOR Task Force for Translation and Cultural Adaptation. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR task force for translation and cultural adaptation. Value in Health, 8(2), 94–104.PubMedCrossRefGoogle Scholar
- 27.Hawkins, M., & Osborne, B. (2007). Questionnaire translation an cultural adaption procedure. Version 1.0. Melbourne: University of Melbourne.Google Scholar
- 28.Willis, G. B. (2004). Cognitive interviewing. A tool for improving questionnaire design. Thousand Oaks: Sage.Google Scholar
- 30.Marsh, H. W., Hau, K.-T., & Grayson, D. (2005). Goodness of fit in structural equation models. In A. Maydeu-Olivares & J. J. McArdle (Eds.), Contemporary psychometrics: A festschrift for Roderick P. McDonald (pp. 275–340). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
- 31.Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.Google Scholar
- 38.Weir, J. P. (2005). Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. Journal of strength and conditioning research/National Strength & Conditioning Association, 19(1), 231–240.Google Scholar
- 41.Bullinger, M., & Kirchberger, I. (1998). Der SF-36-Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen: Hogrefe.Google Scholar
- 46.Leventhal, H., Brissette, I., & Leventhal, E. A. (2003). The common-sense model of self-regulation of health and illness. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 42–65). New York, NY: Routledge.Google Scholar
- 52.Lamers, F., Jonkers, C. C., Bosma, H., Penninx, B. W., Knottnerus, J. A., & van Eijk, J. T. (2008). Summed score of the Patient Health Questionnaire-9 was a reliable and valid method for depression screening in chronically ill elderly patients. Journal of Clinical Epidemiology, 61(7), 679–687.PubMedCrossRefGoogle Scholar
- 54.Muthén, L. K., & Muthén, B. (2010). Mplus user’s guide. Los Angeles: Muthén & Muthén.Google Scholar
- 57.Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2., 2. print. ed.). Hillsdale, NJ: Erlbaum.Google Scholar
- 60.Gramm, L., Kosiol, D., & Farin, E. (2010). Evaluation der deutschen Version des Fragebogens “Perceived efficacy in patient-physician interactions” (PEPPI). DRV-Schriften, 88, 108–110.Google Scholar