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- DOI: 10.2337/dc06-1550
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Patient Interpretation of Neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care.
Vileikyte L, Gonzalez J, Leventhal H, Peyrot M, Rubin R, Garrow A, Ulbrecht J, Cavanagh P, Boulton AJM
Diabetes Care. 2006;29( 12).
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Full-text held externally
- DOI: 10.2337/dc06-1550
Abstract
OBJECTIVE: Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. RESEARCH DESIGN AND METHODS: The Patient Interpretation of Neuropathy (PIN) questionnaire, generated from discussions with clinicians and interviews with patients with DPN, was administered to patients with DPN attending U.K. (n = 325) and U.S. (n = 170) diabetes centers. Psychometric tests of the PIN questionnaire comprised factor analysis, internal consistency, and test-retest reliability. Partial correlations and multivariate regressions established construct and criterion-related validity. The associations of PIN scales to past foot ulceration and foot self-care behaviors were compared with those using a generic measure of illness perception and emotion, the Revised Illness Perception Questionnaire (IPQ-R), which was adapted to neuropathy. RESULTS: Factor analysis of the PIN questionnaire produced 11 scales, which explained 69% of item variance. Nine factors measured patients' common-sense beliefs about DPN and their levels of understanding of DPN-related medical information. Two factors assessed the emotions of worry about potential consequences and anger at practitioners. Most scales demonstrated adequate internal (Cronbach's alpha = 0.62-0.90) and test-retest reliability (Pearson's r = 0.51-0.64). Partial correlations between the PIN and IPQ-R scales in corresponding domains were significant but modest (rp = 0.15-0.26). Finally, PIN scales showed significant associations with past foot ulceration and foot self-care behaviors, thereby confirming criterion validity. CONCLUSIONS: The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.
Keyword(s)
Aged; Cognition; Educational Status; Emotions; Female; Foot; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Patient Education as Topic; Questionnaires; Self Care; prevention & control: Diabetic Foot; psychology: Diabetes Mellitus, Type 1; psychology: Diabetes Mellitus, Type 2; psychology: Diabetic Neuropathies