Topp Marie, Vestbo Jørgen, Mortensen Erik Lykke
Department of Respiratory Medicine, Hvidovre Hospital, Denmark.
Respiratory and Allergy Research Group, Manchester Academic Health Science Centre, University Hospital South Manchester, NHS Foundation Trust, Manchester, United Kingdom.
Chronic Obstr Pulm Dis. 2016 Sep 2;3(4):748-757. doi: 10.15326/jcopdf.3.4.2016.0134.
Understanding non-adherence in patients with chronic obstructive pulmonary disease (COPD) remains challenging. The and the scales of the Beliefs about Medicines Questionnaire (BMQ) are known to correlate with adherence behavior in several chronic diseases including asthma but less is known about COPD. In the present study a COPD-specific BMQ (BMQ-COPD) was translated and administered to Danish COPD outpatients. Our aim was to derive high-quality measures of the 2 dimensions included in the BMQ-COPD. A total of 168 patients with COPD were included from a Danish respiratory outpatient clinic. The Rasch model was used to evaluate psychometric characteristics of the BMQ-COPD and to obtain and scales fulfilling criteria of unidimensionality and overall fit, and with all items showing individual item fit with no local dependencies, and no differential item functioning. Further, we explored the association with disease-related variables and subsequent adherence behavior. Shortened versions of the original and scales fitted the Rasch model and were at least as good as the original scales as predictors of adherence, although only the necessity scale was significantly associated with adherence. In a Danish COPD setting high-quality measures of and could be derived from the BMQ-COPD. The excluded items appear to reflect other dimensions.
了解慢性阻塞性肺疾病(COPD)患者的不依从性仍然具有挑战性。已知药物信念问卷(BMQ)的必要性和关注量表与包括哮喘在内的几种慢性疾病的依从行为相关,但对于COPD的了解较少。在本研究中,一种针对COPD的BMQ(BMQ-COPD)被翻译并应用于丹麦COPD门诊患者。我们的目的是得出BMQ-COPD所包含的两个维度的高质量测量指标。从丹麦一家呼吸门诊诊所纳入了总共168例COPD患者。使用Rasch模型评估BMQ-COPD的心理测量特征,并获得满足单维度性和整体拟合标准的必要性和关注量表,且所有项目均显示个体项目拟合良好,无局部依赖性,也无差异项目功能。此外,我们探讨了与疾病相关变量及后续依从行为的关联。原始必要性和关注量表的简化版本符合Rasch模型,并且作为依从性的预测指标至少与原始量表一样好,尽管只有必要性量表与依从性显著相关。在丹麦的COPD环境中,可以从BMQ-COPD得出高质量的必要性和关注测量指标。排除的项目似乎反映了其他维度。