Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.
Health Qual Life Outcomes. 2022 Jun 3;20(1):90. doi: 10.1186/s12955-022-01993-z.
Patients with multiple long-term conditions often face a variety of challenges arising from the requirements of their health care. Knowledge of perceived treatment burden is crucial for optimizing treatment. In this study, we aimed to create a German version of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and to evaluate its validity.
The steps to translate the MTBQ included forward/back translation, cognitive interviews (n = 6) and a pilot test (n = 7). Psychometric properties of the scale were assessed in a cross-sectional survey with primary care patients aged 65 and older with at least 3 long-term conditions (n = 344). We examined the distribution of responses, dimensionality, internal reliability and construct validity.
Cognitive interviewing and piloting led to minor modifications and showed overall good face validity and acceptability. As expected, we observed a positively skewed response distribution for all items. Reliability was acceptable with McDonald's omega = 0.71. Factor analysis suggested one common factor while model fit indices were inconclusive. Predefined hypotheses regarding the construct validity were supported by negative associations between treatment burden and health-related quality of life, self-rated health, social support, patient activation and medication adherence, and positive associations between treatment burden and number of comorbidities. Treatment burden was found to be higher in female participants (Mdn = 6.82, Mdn = 4.55; U = 11,729, p = 0.001) and participants with mental health diagnoses (Mdn = 9.10, Mdn = 4.55; U = 3172, p = 0.024).
The German MTBQ exhibited good psychometric properties and can be used to assess the perceived treatment burden of patients with multimorbidity.
患有多种长期疾病的患者经常面临各种来自医疗保健需求的挑战。了解感知到的治疗负担对于优化治疗至关重要。在这项研究中，我们旨在创建德国版的多疾病治疗负担问卷（MTBQ）并评估其有效性。
翻译 MTBQ 的步骤包括正向/反向翻译、认知访谈（n=6）和预试验（n=7）。使用横断面调查评估了该量表的心理测量学特性，调查对象为年龄在 65 岁及以上且至少有 3 种长期疾病的初级保健患者（n=344）。我们检查了反应分布、维度、内部可靠性和构念效度。
认知访谈和预试验导致了一些小的修改，并表现出了总体上良好的表面有效性和可接受性。正如预期的那样，我们观察到所有项目的反应分布呈正偏态。可靠性可接受，麦克唐纳ω=0.71。因子分析表明存在一个共同因素，而模型拟合指数则不确定。关于构念效度的预设假设得到了支持，即治疗负担与健康相关的生活质量、自我评估的健康状况、社会支持、患者积极性和药物依从性呈负相关，与合并症的数量呈正相关。女性参与者（Mdn=6.82，Mdn=4.55；U=11729，p=0.001）和有心理健康诊断的参与者（Mdn=9.10，Mdn=4.55；U=3172，p=0.024）的治疗负担较高。
德国 MTBQ 表现出良好的心理测量学特性，可用于评估多种疾病患者的感知治疗负担。
