Patient Interpretation of Neuropathy (PIN) Questionnaire
An instrument for assessment of cognitive and emotional factors associated with foot self-care
- Loretta Vileikyte, MD, PHD12,
- Jeffrey S. Gonzalez, PHD2,
- Howard Leventhal, PHD3,
- Mark F. Peyrot, PHD45,
- Richard R. Rubin, PHD5,
- Adam Garrow, PHD1,
- Jan S. Ulbrecht, MB, BS6,
- Peter R. Cavanagh, PHD6 and
- Andrew J.M. Boulton, FRCP12
- 1University of Manchester, Manchester, U.K.
- 2University of Miami, Miami, Florida
- 3Rutgers University, New Brunswick, New Jersey
- 4Loyola College, Baltimore, Maryland
- 5The Johns Hopkins University, Baltimore, Maryland
- 6Penn State University, State College, Pennsylvania
- Address correspondence and reprint requests to Dr. Loretta Vileikyte, Department of Medicine, University of Manchester, Oxford Road, Manchester M13 WL9, U.K. E-mail: lvileikyte{at}med.miami.edu
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 α = 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.
- CSM, common-sense model of illness behavior
- DPN, diabetic peripheral neuropathy
- IPQ-R, Revised Illness Perception Questionnaire
- PIN questionnaire, Patient Interpretation of Neuropathy questionnaire
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted August 30, 2006.
- Received July 24, 2006.
- DIABETES CARE
