The Illness Belief Network Questionnaire: Development and Evaluation of a Psychosomatic Assessment Tool
-
Farzad Goli
,
Hamidreza Roohafza
,
Awat Feizi
,
Ali Gholamrezaei
,
Mahboubeh Farzanegan
,
Marsa Hashemi
,
Tobias Kube
,
Winfried Rief
Abstract
Objective: Patients’ beliefs and emotions toward an illness can influence their coping responses, illness behaviors, adherence to treatment, quality of life, and even the psychoneuroimmune responses. The aim of present study was to develop and validate a novel questionnaire assessing both rational and irrational beliefs of patients regarding their illness.
Method: In a cross sectional methodological study, the items of the Illness Belief Network (IBN) were developed regarding patients and clients’ opinions about and attribution of their disease extracted from 400 clinical interviews and were coded based on Leventhal’s self-regulation model. An expert panel coded the items. A total of 400 patients with different medical conditions completed the questionnaire. Participants additionally rated the Illness Perceptions Questionnaire in its revised form (IPQ-R) to assess convergent validity. Construct validity was examined by conducting exploratory and confirmatory factor analysis. The Cronbach alpha and Intracluster Correlation Coefficient (ICC) were used for examining Internal consistency and test-retest reliability of the IBN.
Results: The IBN questionnaire was finalized with 84 items, and the results of factor analysis revealed 5 factors: psychosocial causes, environmental causes, control, meaning, and consequence/timeline; extracted factors were confirmed by confirmatory factor analysis. Cronbach’s α coefficient for scale was 0.92 and it ranged from 0.79 to 0.89 for the subscales. IBN indicated excellent test-retest reliability results based on ICC 0.842(95%CI: 0.798-0.846). The correlation coefficients of all items exceeded the prespecified acceptable value of 0.40, indicating satisfactory item discriminant validity, and correlation between IBN and IPQ-R subscales were statistically significant (all p values < 0.01), indicating acceptable convergent validity.
Conclusion: The IBN questionnaire is a valid and reliable phenomenological, non-judging, and clinical tool to assess patient’s rational and irrational or faith-based beliefs about the illness. This tool can be used to improve doctor-patient communication by exploring the complex nature of human thinking.
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7. Fortune DG, Richards HL, Griffiths CE, Main CJ. Psychological stress, distress and disability in patients with psoriasis: consensus and variation in the contribution of illness perceptions, coping and alexithymia. Br J Clin Psychol. 2002;41(Pt 2):157-74.
8. Moss‐Morris R, Petrie KJ, Weinman J. Functioning in chronic fatigue syndrome: do illness perceptions play a regulatory role? Br J Health Psychol. 1996;1(1):15-25.
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11. Goli F, Farzanegan M. The Ritual Effect: The Healing Response to Forms and Performs. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 117-132.
12. Sobel DS. Rethinking medicine: improving health outcomes with cost-effective psychosocial interventions. Psychosom Med. 1995;57(3):234-44.
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16. Whitmarsh A, Koutantji M, Sidell K. Illness perceptions, mood and coping in predicting attendance at cardiac rehabilitation. Br J Health Psychol. 2003;8(Pt 2):209-21.
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21. Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015;30(11):1361-85.
22. Derakhshan A, Manshaei G, Afshar H, Goli F. Effect of a bioenergy economy program on pain control, depression, and anxiety in patients with migraine headache. International Journal of Body, Mind and Culture. 2016:30-45.
23. Goli F. Bioenergy economy: a methodological study on bioenergy-based therapies: Xlibris Corporation; 2010.
24. Goli F. Medical Practice in/with the Semiosphere. In: Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 217-39.
25. Goli F, Fard RJ. How Can We Reconstruct the Health Anticipation? In Goli F. (eds) Biosemiotic Medicine: Springer, Cham; 2016. p 95-115.
26. Leventhal H, Benyamini Y, Brownlee S, Diefenbach M, Leventhal E, Patrick-Miller L. Illness representations: theoretical foundations. Perceptions of health and illnes. In Petrie KJ, Weinman J, (ed) Perceptions of health and illness: current research and applications London: Harwood Publishers Ltd;1997. p 19-45.
27. Bazzazian S, Besharat MA. Reliability and validity of a Farsi version of the brief illness perception questionnaire. Procedia Soc Behav Sci. 2010; 5: 962-5.
28. Gorsuch RL. Factor analysis. 2nd ed: Hillsdale, NJ: Erlbaum; 1983.
29. DeVellis RF. Scale development: Theory and applications. Sage publications; 2016.
30. Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980; 88(3):588-606.
31. Chin CL, Yao G. Convergent Validity. In: Michalos AC, editor. Encyclopedia of Quality of Life and Well-Being Research. Springer, Netherlands; 2014.
32. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
33. Carel HH. Illness, phenomenology, and philosophical method. Theor Med Bioeth. 2013;34(4):345-57.
34. Fritzsche K. What is Psychosomatic Medicine?. In: Fritzsche K., McDaniel S., Wirsching M. (eds) Psychosomatic Medicine. Springer, New York, NY; 2014. P 3-9.
35. Marcum JA. Biomechanical and phenomenological models of the body, the meaning of illness and quality of care. Med Health Care Philos. 2004;7(3):311-20.
36. Bebbington PE. The content and context of compliance. Int Clin Psychopharmacol. 1995;9 Suppl 5:41-50.
37. Safran JD, Reading R. Mindfulness, metacommunication, and affect regulation in psychoanalytic treatment. Mindfulness and the therapeutic relationship. 2008:122-40.
38. Hekler EB, Lambert J, Leventhal E, Leventhal H, Jahn E, Contrada RJ. Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans. J Behav Med. 2008;31(5):391-400.
39. Levy RL. Exploring the intergenerational transmission of illness behavior: from observations to experimental intervention. Ann Behav Med. 2011;41(2):174-82.
40. Lim JW, Gonzalez P, Wang-Letzkus MF, Ashing-Giwa KT. Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors. Support Care Cancer. 2009;17(9):1137-47.
41. Skevington SM, Gunson KS, O'Connell KA. Introducing the WHOQOL-SRPB BREF: developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Qual Life Res. 2013;22(5):1073-83.
42. Exton MS, King MG, Husband AJ. Behavioral conditioning of immunity. Psychoneuroimmunology: Springer; 1999. p. 453-71.
43. Yan Q. The role of psychoneuroimmunology in personalized and systems medicine. Methods Mol Biol. 2012;934:3-19.
44. McLaughlin LA, Braun KL. Asian and Pacific Islander cultural values: considerations for health care decision making. Health Soc Work. 1998;23(2):116-26.
45. Roth RS. A biopsychosocial perspective on the placebo effect: Comment on Benedetti Benedetti F, Maggi G, Lopiano L, Lanotte M, Rainero I, Vighetti S, et al. Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome. Prevention & Treatment. 2003; 6(1): Article 8c.
46. Goli F, Monajemi A, Ahmadzadeh GH, Malekian A. How to Prescribe Information: Health Education Without Health Anxiety and Nocebo Effects. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 151-93.
47. Schmidt S, Walach H. Making Sense in the Medical System: Placebo, Biosemiotics, and the Pseudomachine. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 195-215.
48. Walach H. Placebo controls: historical, methodological and general aspects. Philos Trans R Soc Lond B Biol Sci. 2011;366(1572):1870-8.
49. Becker CM, Glascoff MA, Felts WM. Salutogenesis 30 Years Later: Where Do We Go from here? International Electronic Journal of Health Education. 2010;13:25-32.
50. Rutherford BR, Pott E, Tandler JM, Wall MM, Roose SP, Lieberman JA. Placebo response in antipsychotic clinical trials: a meta-analysis. JAMA Psychiatry. 2014;71(12):1409-21.
2. Petrie KJ, Weinman J, Sharpe N, Buckley J. Role of patients' view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. Bmj. 1996;312(7040):1191-4.
3. Benedetti F, Dogue S. Different Placebos, Different Mechanisms, Different Outcomes: Lessons for Clinical Trials. PLoS One. 2015;10(11):e0140967.
4. Juergens MC, Seekatz B, Moosdorf RG, Petrie KJ, Rief W. Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later. J Psychosom Res. 2010;68(6):553-60.
5. Nestoriuc Y, von Blanckenburg P, Schuricht F, Barsky AJ, Hadji P, Albert US, et al. Is it best to expect the worst? Influence of patients' side-effect expectations on endocrine treatment outcome in a 2-year prospective clinical cohort study. Ann Oncol. 2016;27(10):1909-15.
6. Zoeckler N, Kenn K, Kuehl K, Stenzel N, Rief W. Illness perceptions predict exercise capacity and psychological well-being after pulmonary rehabilitation in COPD patients. J Psychosom Res. 2014;76(2):146-51.
7. Fortune DG, Richards HL, Griffiths CE, Main CJ. Psychological stress, distress and disability in patients with psoriasis: consensus and variation in the contribution of illness perceptions, coping and alexithymia. Br J Clin Psychol. 2002;41(Pt 2):157-74.
8. Moss‐Morris R, Petrie KJ, Weinman J. Functioning in chronic fatigue syndrome: do illness perceptions play a regulatory role? Br J Health Psychol. 1996;1(1):15-25.
9. Vaughan R, Morrison L, Miller E. The illness representations of multiple sclerosis and their relations to outcome. Br J Health Psychol. 2003;8(Pt 3):287-301.
10. Hagger MS, Orbell S. A meta-analytic review of the common-sense model of illness representations. Psychol Health. 2003;18(2):141-84.
11. Goli F, Farzanegan M. The Ritual Effect: The Healing Response to Forms and Performs. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 117-132.
12. Sobel DS. Rethinking medicine: improving health outcomes with cost-effective psychosocial interventions. Psychosom Med. 1995;57(3):234-44.
13. Morgan K, Villiers-Tuthill A, Barker M, McGee H. The contribution of illness perception to psychological distress in heart failure patients. BMC Psychol. 2014;2(1):50.
14. Petrie KJ, Jago LA, Devcich DA. The role of illness perceptions in patients with medical conditions. Curr Opin Psychiatry. 2007;20(2):163-7.
15. Weinman J, Petrie KJ, Moss-Morris R, Horne R. The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health. 1996;11(3):431-45.
16. Whitmarsh A, Koutantji M, Sidell K. Illness perceptions, mood and coping in predicting attendance at cardiac rehabilitation. Br J Health Psychol. 2003;8(Pt 2):209-21.
17. Cordingley L, Prajapati R, Plant D, Maskell D, Morgan C, Ali FR, et al. Impact of psychological factors on subjective disease activity assessments in patients with severe rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(6):861-8.
18. Scharloo M, Kaptein AA, Weinman J, Hazes JM, Willems LN, Bergman W, et al. Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis. J Psychosom Res. 1998;44(5):573-85.
19. Ashley L, Smith AB, Keding A, Jones H, Velikova G, Wright P. Psychometric evaluation of the revised Illness Perception Questionnaire (IPQ-R) in cancer patients: confirmatory factor analysis and Rasch analysis. J Psychosom Res. 2013;75(6):556-62.
20. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The revised illness perception questionnaire (IPQ-R). Psychol Health. 2002;17(1):1-16.
21. Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015;30(11):1361-85.
22. Derakhshan A, Manshaei G, Afshar H, Goli F. Effect of a bioenergy economy program on pain control, depression, and anxiety in patients with migraine headache. International Journal of Body, Mind and Culture. 2016:30-45.
23. Goli F. Bioenergy economy: a methodological study on bioenergy-based therapies: Xlibris Corporation; 2010.
24. Goli F. Medical Practice in/with the Semiosphere. In: Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 217-39.
25. Goli F, Fard RJ. How Can We Reconstruct the Health Anticipation? In Goli F. (eds) Biosemiotic Medicine: Springer, Cham; 2016. p 95-115.
26. Leventhal H, Benyamini Y, Brownlee S, Diefenbach M, Leventhal E, Patrick-Miller L. Illness representations: theoretical foundations. Perceptions of health and illnes. In Petrie KJ, Weinman J, (ed) Perceptions of health and illness: current research and applications London: Harwood Publishers Ltd;1997. p 19-45.
27. Bazzazian S, Besharat MA. Reliability and validity of a Farsi version of the brief illness perception questionnaire. Procedia Soc Behav Sci. 2010; 5: 962-5.
28. Gorsuch RL. Factor analysis. 2nd ed: Hillsdale, NJ: Erlbaum; 1983.
29. DeVellis RF. Scale development: Theory and applications. Sage publications; 2016.
30. Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980; 88(3):588-606.
31. Chin CL, Yao G. Convergent Validity. In: Michalos AC, editor. Encyclopedia of Quality of Life and Well-Being Research. Springer, Netherlands; 2014.
32. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
33. Carel HH. Illness, phenomenology, and philosophical method. Theor Med Bioeth. 2013;34(4):345-57.
34. Fritzsche K. What is Psychosomatic Medicine?. In: Fritzsche K., McDaniel S., Wirsching M. (eds) Psychosomatic Medicine. Springer, New York, NY; 2014. P 3-9.
35. Marcum JA. Biomechanical and phenomenological models of the body, the meaning of illness and quality of care. Med Health Care Philos. 2004;7(3):311-20.
36. Bebbington PE. The content and context of compliance. Int Clin Psychopharmacol. 1995;9 Suppl 5:41-50.
37. Safran JD, Reading R. Mindfulness, metacommunication, and affect regulation in psychoanalytic treatment. Mindfulness and the therapeutic relationship. 2008:122-40.
38. Hekler EB, Lambert J, Leventhal E, Leventhal H, Jahn E, Contrada RJ. Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans. J Behav Med. 2008;31(5):391-400.
39. Levy RL. Exploring the intergenerational transmission of illness behavior: from observations to experimental intervention. Ann Behav Med. 2011;41(2):174-82.
40. Lim JW, Gonzalez P, Wang-Letzkus MF, Ashing-Giwa KT. Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors. Support Care Cancer. 2009;17(9):1137-47.
41. Skevington SM, Gunson KS, O'Connell KA. Introducing the WHOQOL-SRPB BREF: developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Qual Life Res. 2013;22(5):1073-83.
42. Exton MS, King MG, Husband AJ. Behavioral conditioning of immunity. Psychoneuroimmunology: Springer; 1999. p. 453-71.
43. Yan Q. The role of psychoneuroimmunology in personalized and systems medicine. Methods Mol Biol. 2012;934:3-19.
44. McLaughlin LA, Braun KL. Asian and Pacific Islander cultural values: considerations for health care decision making. Health Soc Work. 1998;23(2):116-26.
45. Roth RS. A biopsychosocial perspective on the placebo effect: Comment on Benedetti Benedetti F, Maggi G, Lopiano L, Lanotte M, Rainero I, Vighetti S, et al. Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome. Prevention & Treatment. 2003; 6(1): Article 8c.
46. Goli F, Monajemi A, Ahmadzadeh GH, Malekian A. How to Prescribe Information: Health Education Without Health Anxiety and Nocebo Effects. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 151-93.
47. Schmidt S, Walach H. Making Sense in the Medical System: Placebo, Biosemiotics, and the Pseudomachine. In Goli F. (eds) Biosemiotic Medicine. Springer, Cham; 2016. p 195-215.
48. Walach H. Placebo controls: historical, methodological and general aspects. Philos Trans R Soc Lond B Biol Sci. 2011;366(1572):1870-8.
49. Becker CM, Glascoff MA, Felts WM. Salutogenesis 30 Years Later: Where Do We Go from here? International Electronic Journal of Health Education. 2010;13:25-32.
50. Rutherford BR, Pott E, Tandler JM, Wall MM, Roose SP, Lieberman JA. Placebo response in antipsychotic clinical trials: a meta-analysis. JAMA Psychiatry. 2014;71(12):1409-21.
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| Issue | Vol 16 No 2 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v16i2.5819 | |
| Keywords | ||
| Illness Belief Perception Psychosomatic Medicine Reliability and Validity | ||
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How to Cite
1.
Goli F, Roohafza H, Feizi A, Gholamrezaei A, Farzanegan M, Hashemi M, Kube T, Rief W. The Illness Belief Network Questionnaire: Development and Evaluation of a Psychosomatic Assessment Tool. Iran J Psychiatry. 2021;16(2):177-186.
