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Development and Preliminary Psychometrics of the Exercise Therapy Burden Questionnaire for Patients With Chronic Conditions

  • William Martin
    Correspondence
    Corresponding author William Martin, MD, Cochin Hospital, Physical Medicine and Rehabilitation, 27 rue du faubourg Saint-Jacques, 75014 Paris, France.
    Affiliations
    Sorbonne Paris Cité, INSERM UMR 1153, Cochin Hospital, Paris, France
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  • Clémence Palazzo
    Affiliations
    Sorbonne Paris Cité, INSERM UMR 1153, Cochin Hospital, Paris, France

    Department of Rehabilitation for Musculoskeletal and Spine Diseases, Cochin Hospital, Paris, France

    Paris Descartes University, Paris, France
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  • Serge Poiraudeau
    Affiliations
    Sorbonne Paris Cité, INSERM UMR 1153, Cochin Hospital, Paris, France

    Department of Rehabilitation for Musculoskeletal and Spine Diseases, Cochin Hospital, Paris, France

    Paris Descartes University, Paris, France
    Search for articles by this author
Published:April 17, 2017DOI:https://doi.org/10.1016/j.apmr.2017.03.015

      Abstract

      Objective

      To develop and validate a self-reporting questionnaire assessing the burden of exercise therapy for patients with chronic conditions.

      Design

      Measurement properties of an instrument.

      Setting

      Outpatient clinics and tertiary care hospital.

      Participants

      Patients (N=201) with at least 1 chronic condition and performing exercise therapy.

      Interventions

      Not applicable.

      Main Outcome Measures

      The dimensional structure of the questionnaire was assessed by principal component analysis. Construct validity of the instrument was assessed by exploring convergent validity with the Treatment Burden Questionnaire (TBQ) and divergent validity with pain, self-efficacy, treatment satisfaction, and health state. Reliability was assessed with the Cronbach α coefficient, a test-retest method using the intraclass correlation coefficient (ICC), and Bland-Altman plotting.

      Results

      A preliminary list of items was developed from semistructured interviews with 28 patients and reviewed by 2 expert physicians. Items obtained were reduced. Then a sample of 163 patients was used to measure the psychometrics of the Exercise Therapy Burden Questionnaire (ETBQ), consisting of 10 items. Principal component analysis extracted 1 dimension. The Cronbach α was .86 (.82–.89). Test-retest reliability (n=24 patients) was good with an ICC of .93 (.85–.97), and Bland-Altman analysis did not reveal a systematic trend. The ETBQ showed expected convergent validity with the TBQ (ρ=.52) and expected divergent validity with pain (ρ=.37), self-efficacy (ρ=−.34), treatment satisfaction (ρ=−.49), and perceived health state (ρ=−.28).

      Conclusions

      The ETBQ is the first questionnaire assessing exercise therapy burden in patients with chronic conditions. Its psychometric properties are promising.

      Keywords

      List of abbreviations:

      EQ-5D (European Quality of Life–5 Dimensions), ETBQ (Exercise Therapy Burden Questionnaire), ICC (intraclass correlation coefficient), TBQ (Treatment Burden Questionnaire)
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