School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, 5 Robert Sobukwe Road, Private Bag X17, Bellville, 7535, South Africa.
Centre for Population, Family & Health, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, BE-2000 Antwerp, Belgium.
AIDS Res Ther. 2022 Aug 21;19(1):39. doi: 10.1186/s12981-022-00464-1.
The chronic illness trajectory and its outcomes are well explained by the concept of illness identity; the extent to which ill individuals have integrated their diagnosed chronic illness into their identity or sense of self. The capacity to measure illness identity in people living with HIV (PLHIV) is still relatively unexplored. However, this is potentially useful to help us understand how outcomes for PLHIV could be improved and sustained. This paper aims to explore the cross-cultural adaptation of a Belgian developed Illness Identity Questionnaire (IIQ) and validate the instrument using a sample of South African adults living with HIV. We followed a phased scale adaptation and validation process which included an investigation of conceptual, item, semantic and operational equivalence and also examined the psychometric properties of the IIQ. The concept of illness identity with its four factors; engulfment, rejection, acceptance and enrichment in PLHIV, was found to be relevant within this context. Five items from the original IIQ were excluded from the adapted IIQ due to either semantic insufficiency and/or inadequate measurement equivalence. The mode of administration of the IIQ was changed to accommodate current study participants. The original four factor 25-item model did not fit current data, however, a better contextualized, four-factor, 20-item model was identified and found valid in the current setting. The results showed adequate statistical fit; χ/d.f. = 1.516, RMSEA = 0.076, SRMR = 0.0893, and CFI = 0.909. Convergent and discriminant validity were also tenable. The cross-cultural adaptation and validation of the IIQ was successful, resulting in the availability of an instrument capable of measuring illness identity in PLHIV in a high HIV prevalence and resource-constrained setting. This therefore addresses the paucity of information and expands on knowledge about illness identity.
慢性疾病轨迹及其结果可以很好地用疾病认同概念来解释；即被诊断患有慢性疾病的个体将其疾病纳入自身认同或自我意识的程度。在感染艾滋病毒的人群（PLHIV）中衡量疾病认同的能力仍然相对未知。然而，这对于帮助我们理解如何改善和维持 PLHIV 的结果可能是有用的。本文旨在探索比利时开发的疾病认同问卷（IIQ）的跨文化适应性，并使用南非成年人 HIV 感染样本验证该工具。我们遵循了分阶段的量表适应和验证过程，其中包括对概念、项目、语义和操作等效性的调查，以及对 IIQ 的心理测量特性进行了检验。在这种情况下，PLHIV 的疾病认同及其四个因素；吞噬、排斥、接受和丰富，被认为是相关的。由于语义不足和/或测量等效性不足，原始 IIQ 中的五个项目被排除在适应的 IIQ 之外。IIQ 的管理模式因当前研究参与者而异。原始的四因素 25 项模型不符合当前数据，但确定了一个更具上下文意义的、四因素、20 项模型，并且在当前环境中被证明是有效的。结果表明具有足够的统计拟合度；χ/d.f. = 1.516，RMSEA = 0.076，SRMR = 0.0893，和 CFI = 0.909。同时还具有可接受的收敛和判别有效性。IIQ 的跨文化适应和验证是成功的，因此提供了一种能够在高 HIV 流行率和资源受限的环境中测量 PLHIV 疾病认同的工具。这因此解决了信息匮乏的问题，并扩展了对疾病认同的认识。
