Immunology and Rheumatology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Research Unit in Clinical Epidemiology, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
PLoS One. 2019 Jul 22;14(7):e0219921. doi: 10.1371/journal.pone.0219921. eCollection 2019.
Risk perception is a multidimensional phenomenon that describes the individual's judgment of the likelihood of experiencing something unpleasant. Risk perception helps to understand how rheumatoid arthritis patients perceive disease-related-risks. We developed and validated a risk perception questionnaire for Spanish speaking rheumatoid arthritis patients.
The questionnaire development and validation was performed in 3 steps, using respective convenience samples. Step-1 included the conceptual model construction, 20 patient's interviews to identify components from the conceptual model-dimensions and 11 healthcare provider´s consultations who identified RA related manifestations/complications (network and frequencies analysis). Step-2 consisted of item generation and reduction and questionnaire feasibility (n = 100). Step-3 consisted of the questionnaire psychometric validation (n = 270), which included content, face, construct (exploratory factor analysis) and criterion validity (logistic regression analysis) and consistency and stability (Cronbach's α and test-retest).
Samples were representative of typical RA outpatients. Initial conceptual model included 7 dimensions, 3 for probability and 1 each, for responsibility, prevention, control and for severity (Step-1). The final version was considered feasible by the patients and included 27 items (Step-2). A five-factor model was most appropriated and resulted in 68.8% of the variance explained: Cronbach's α = 0.90, intraclass-correlation-coefficient = 0.93 (95% CI = 0.90-0.95). A positive relation between number of external criteria from the charts and risk perception was found; all items had ≥80% agreement from experts; patients agreed about item´s semantic clarity (89%) and format adequacy (97%), (Step-3).
The risk perception questionnaire was valid and reliable to evaluate risk perception construct in RA outpatients; it can be incorporated to routine care and clinical research, and guide interventions to improve patient's health behaviors.
风险感知是一种多维现象，描述了个体对经历不愉快事件的可能性的判断。风险感知有助于了解类风湿关节炎患者如何感知与疾病相关的风险。我们开发并验证了一种用于西班牙语类风湿关节炎患者的风险感知问卷。
问卷的开发和验证分三个步骤进行，使用了相应的便利样本。步骤 1 包括概念模型构建、对 20 名患者进行访谈以从概念模型维度中识别组件以及 11 名医疗保健提供者的咨询，以确定 RA 相关表现/并发症（网络和频率分析）。步骤 2 包括项目生成和缩减以及问卷可行性（n = 100）。步骤 3 包括问卷心理测量学验证（n = 270），包括内容、表面、结构（探索性因素分析）和标准有效性（逻辑回归分析）以及一致性和稳定性（Cronbach's α 和测试-重测）。
样本代表了典型的类风湿关节炎门诊患者。初始概念模型包括 7 个维度，3 个用于概率，1 个用于责任、预防、控制和严重程度（步骤 1）。最终版本被患者认为是可行的，包括 27 个项目（步骤 2）。五因素模型最合适，可解释 68.8%的方差：Cronbach's α = 0.90，组内相关系数 = 0.93（95%置信区间= 0.90-0.95）。发现图表中的外部标准数量与风险感知之间存在正相关；所有项目都得到了专家≥80%的一致性；患者对项目的语义清晰度（89%）和格式适宜性（97%）表示同意（步骤 3）。
风险感知问卷在评估类风湿关节炎门诊患者的风险感知结构方面是有效和可靠的；它可以纳入常规护理和临床研究，并指导干预措施以改善患者的健康行为。
