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Development of a Multimorbidity Illness Perceptions Scale (MULTIPleS)

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  • Chris J Gibbons
  • Cassandra Kenning
  • Peter A Coventry
  • Penny Bee
  • Christine Bundy
  • Louise Fisher
  • Peter Bower

Abstract

Background: Illness perceptions are beliefs about the cause, nature and management of illness, which enable patients to make sense of their conditions. These perceptions can predict adjustment and quality of life in patients with single conditions. However, multimorbidity (i.e. patients with multiple long-term conditions) is increasingly prevalent and a key challenge for future health care delivery. The objective of this research was to develop a valid and reliable measure of illness perceptions for multimorbid patients. Methods: Candidate items were derived from previous qualitative research with multimorbid patients. Questionnaires were posted to 1500 patients with two or more exemplar long-term conditions (depression, diabetes, osteoarthritis, coronary heart disease and chronic obstructive pulmonary disease). Data were analysed using factor analysis and Rasch analysis. Rasch analysis is a modern psychometric technique for deriving unidimensional and intervally-scaled questionnaires. Results: Questionnaires from 490 eligible patients (32.6% response) were returned. Exploratory factor analysis revealed five potential subscales ‘Emotional representations’, ‘Treatment burden’, ‘Prioritising conditions’, ‘Causal links’ and ‘Activity limitations’. Rasch analysis led to further item reduction and the generation of a summary scale comprising of items from all scales. All scales were unidimensional and free from differential item functioning or local independence of items. All scales were reliable, but for each subscale there were a number of patients who scored at the floor of the scale. Conclusions: The MULTIPleS measure consists of five individual subscales and a 22-item summary scale that measures the perceived impact of multimorbidity. All scales showed good fit to the Rasch model and preliminary evidence of reliability and validity. A number of patients scored at floor of each subscale, which may reflect variation in the perception of multimorbidity. The MULTIPleS measure will facilitate research into the impact of illness perceptions on adjustment, clinical outcomes, quality of life, and costs in patients with multimorbidity.

Suggested Citation

  • Chris J Gibbons & Cassandra Kenning & Peter A Coventry & Penny Bee & Christine Bundy & Louise Fisher & Peter Bower, 2013. "Development of a Multimorbidity Illness Perceptions Scale (MULTIPleS)," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-12, December.
    • Handle: RePEc:plo:pone00:0081852
    DOI: 10.1371/journal.pone.0081852
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    References listed on IDEAS

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    1. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    1. Cheng Cheng & Jie Bai & Cong‐Yan Yang & Ming Li & Kerry Inder & Sally Wai‐Chi Chan, 2019. "Patients' experiences of coping with multiple chronic conditions: A qualitative descriptive study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4400-4411, December.
    2. Penny Bee & Chris Gibbons & Patrick Callaghan & Claire Fraser & Karina Lovell, 2016. "Evaluating and Quantifying User and Carer Involvement in Mental Health Care Planning (EQUIP): Co-Development of a New Patient-Reported Outcome Measure," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-14, March.

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