Cross-cultural adaptation of the Beliefs about Medicines Questionnaire into Portuguese
Keywords:
Psychometrics, Questionnaires, Medication adherence, Reproducibility of results, PortugalAbstract
CONTEXT AND OBJECTIVES: The Beliefs about Medicines Questionnaire (BMQ-Specific) has proven useful for measuring patients’ beliefs and associating them with non-adherence to treatment in several illness groups. The aim was to cross-culturally adapt the BMQ-Specific into Portuguese for the general populationof medicine users. DESIGN AND SETTING: Cross-sectional study conducted among users of public hospitals and outpatient clinics in Guarda and Covilhã, Portugal. METHODS: The BMQ-Specific was translated using international recommendations for performing cross-cultural adaptation and was administered to 300 patients. An initial principal component analysis (PCA)was conducted with the extraction criterion of eigenvalue > 1.0, followed by a second PCA with restriction to two components. Reliability was assessed by calculating Cronbach’s alpha coefficient. RESULTS: The mean scores obtained for the Necessity and Concerns subscales of the Portuguese BMQ-Specific were 19.9 (standard deviation, SD = 2.8) (range 10 to 25) and 17.7 (SD = 3.9) (range 6 to 30), respectively. The first PCA produced an unstable three-component structure for the Portuguese BMQ-Specific. The final PCA solution yielded a two-component structure identical to the original English version (a five-item Necessity and a six-item Concerns subscale), and explained 44% of the variance. Cronbach’s alpha for the complete Portuguese BMQ-Specific was 0.70, and 0.76 and 0.67 for the Necessity and Concerns subscales, respectively. CONCLUSION: A cross-culturally adapted Portuguese version of the BMQ-Specific questionnaire for use among the general population of medicine users was obtained, presenting good internal consistency and component structure identical to the original English version.
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References
World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: WHO; 2003.
Stuart B, Davidoff A, Lopert R, et al. Does medication adherence lower Medicare spending among beneficiaries with diabetes? Health Serv Res. 2011;46(4):1180-99.
Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clin Ther. 2011;33(1):74-109.
Hong JS, Kang HC. Relationship between oral antihyperglycemic medication adherence and hospitalization, mortality, and healthcare costs in adult ambulatory care patients with type 2 diabetes in South Korea. Med Care. 2011;49(4):378-84.
Dragomir A, Côté R, Roy L, et al. Impact of adherence to antihypertensive agents on clinical outcomes and hospitalization costs. Med Care. 2010;48(5):418-25.
Pittman DG, Tao Z, Chen W, Stettin GD. Antihypertensive medication adherence and subsequent healthcare utilization and costs. Am J Manag Care. 2010;16(8):568-76.
Williams LK, Pladevall M, Xi H, et al. Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma. J Allergy Clin Immunol. 2004;114(6):1288-93.
Le TT, Bilderback A, Bender B, et al. Do asthma medication beliefs mediate the relationship between minority status and adherence to therapy? J Asthma. 2008;45(1):33-7.
Horne R, Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002;17(1):17-32. Available from: http://www.tandfonline.com/doi/abs/10.1080/08870440290001502#preview Accessed in 2012 (Jun 25).
Horne R, Weinman J. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47(6):555-67.
Horne R. Compliance, adherence and concordance. In: Taylor K, editor. Pharmacy Practice. London: Taylor and Francis; 2001. p.165-84.
Clifford S, Barber N, Horne R. Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework. J Psychosom Res. 2008;64(1):41-6.
Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychology Health. 1999;14(1):1-24. Available from: http://www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Management/References/2006---May/08/The-Beliefs-About-Medicines-Questionnaire--the-development-and-evaluation-of-a-new-method-for-assess/ Accessed in 2012 (Jun 25).
Mann DM, Ponieman D, Leventhal H, Halm EA. Predictors of adherence to diabetes medications: the role of disease and medication beliefs. J Behav Med. 2009;32(3):278-84.
Ross S, Walker A, MacLeod MJ. Patient compliance in hypertension: role of illness perceptions and treatment beliefs. J Hum Hypertens. 2004;18(9):607-13.
Menckeberg TT, Bouvy ML, Bracke M, et al. Beliefs about medicines predict refill adherence to inhaled corticosteroids. J Psychosom Res. 2008;64(1):47-54.
Bucks RS, Hawkins K, Skinner TC, et al. Adherence to treatment in adolescents with cystic fibrosis: the role of illness perceptions and treatment beliefs. J Pediatr Psychol. 2009;34(8):893-902.
Aikens JE, Nease DE Jr, Nau DP, Klinkman MS, Schwenk TL. Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication. Ann Fam Med. 2005;3(1):23-30.
Jónsdóttir H, Friis S, Horne R, et al. Beliefs about medications: measurement and relationship to adherence in patients with severe mental disorders. Acta Psychiatr Scand. 2009;119(1):78-84.
Clatworthy J, Bowskill R, Parham R, et al. Understanding medication non-adherence in bipolar disorders using a Necessity-Concerns Framework. J Affect Disord. 2009;116(1-2):51-5.
Horne R, Parham R, Driscoll R, Robinson A. Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis. 2009;15(6):837-44.
Horne R, Cooper V, Gellaitry G, Date HL, Fisher M. Patients' perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework. J Acquir Immune Defic Syndr. 2007;45(3):334-41.
Neame R, Hammond A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford). 2005;44(6):762-7.
Tibaldi G, Clatworthy J, Torchio E, et al. The utility of the Necessity--Concerns Framework in explaining treatment non-adherence in four chronic illness groups in Italy. Chronic Illn. 2009;5(2):129-33.
Mahler C, Hermann K, Horne R, et al. Patients' Beliefs about Medicines in a primary care setting in Germany. J Eval Clin Pract. 2012;18(2):409-13.
Hedenrud T, Jonsson P, Linde M. Beliefs about medicines and adherence among Swedish migraineurs. Ann Pharmacother. 2008;42(1):39-45.
Gauchet A, Tarquinio C, Fischer G. Psychosocial predictors of medication adherence among persons living with HIV. Int J Behav Med. 2007;14(3):141-50.
Wild D, Grove A, Martin M, et al. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94-104.
Streiner DL, Norman GR. Health Measurement Scales: a practical guide to their development and use. 4th ed. Oxford: Oxford University Press; 2008.
Costello AB, Osborne JW. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7):1-9.
Comrey AL, Lee HB. A first course in factor analysis. Hillsdale: Erlbaum; 1992.
Pett MA, Lackey NR, Sullivan JJ. Making sense of factor analysis: the use of factor analysis for instrument development in health care research. Thousand Oaks: SAGE Publications; 2003.
Nunnally J. Psychometric theory. 2nd ed. New York: McGraw-Hill; 1978.
Silva P, Luís S, Biscaia A. Polimedicação: um estudo de prevalência nos Centros de Saúde do Lumiar e de Queluz [Polymedication: a prevalence study at the Lumiar and Queluz health centres]. Rev Port Clin Geral. 2004;20(3):323-36.
Granas AG, Haugbølle LS, Kälvemark Sporrong S. Lost in translation? Comparing translations of the beliefs about medicines questionnaire into the three Scandinavian languages. Pharm Pract (Internet). 2010;8(suppl 1):75.