Sensibility assessment of the HIV Disability Questionnaire

Abstract

Purpose: Our purpose was to assess the sensibility of the human immunodeficiency virus (HIV) Disability Questionnaire (HDQ), the first HIV-specific disability questionnaire. Methods: We administered the HDQ, a sensibility questionnaire and a structured qualitative interview to 22 adults living with HIV and five experienced clinicians. We considered the HDQ sensible if median scores on the sensibility questionnaire were ≥5 for adults living with HIV and ≥4 for clinicians for at least 80% of the items. We analyzed the interview data using directed qualitative content analytical techniques. Results: Questionnaire scores were ≥5 for 88% (15/17) of the items and ≥4 for 100% (17/17) of the items for adults living with HIV and clinicians, respectively. The interview analysis indicated participants felt the HDQ possessed face and content validity in all disability dimensions, had adequate response options, was easy to complete, and adequately captured the episodic nature of disability. Participants had mixed responses about the questionnaire title and provided recommendations to refine item wording and response options. Conclusions: The HDQ appears sensible for use with adults living with HIV. Next steps include further measurement property assessment. The HDQ may be used by rehabilitation clinicians and researchers to assess disability experienced by adults living with HIV.

Implications for Rehabilitation

• As people with HIV infection live longer, individuals may face a range of health-related challenges due to the disease, concurrent health conditions and the potential adverse effects of treatment. Together, these health-related challenges may be termed disability.

• The HIV Disability Questionnaire (HDQ) is the first HIV-specific instrument developed to describe the presence, severity and episodic nature of the disability experienced by adults living with HIV. The HDQ is comprised of four domains including symptoms and impairments, uncertainty about future health, difficulties carrying out day-to-day activities, and challenges to social inclusion.

• The HDQ appears sensible for use with adults living with HIV, possessing face and content validity and ease of use in all four domains as well as describing the daily episodic nature of disability.

• The HDQ may be used by rehabilitation clinicians and researchers to assess disability experienced by adults living with HIV.

Keywords::

• Disability evaluation
• HIV/AIDS
• HIV Disability Questionnaire
• reliability and validity
• sensibility

Acknowledgements

We gratefully acknowledge the members of the Community Advisory Committee including James Murray (Ontario Ministry of Health and Long-Term Care), Meskerem Tebeje (Voices of Positive Women), Ken King (Canadian Working Group on HIV and Rehabilitation), and Rob Alexander (HIVER Consulting) for their contributions throughout this research.

Declaration of Interest: This research was supported by a Michael G. DeGroote Fellowship (McMaster University). Dr. Kelly O’Brien was supported by a Fellowship from the Canadian Institutes of Health Research (CIHR), HIV/AIDS Research Program and Michael G. DeGroote Postdoctoral Fellowship (McMaster University). Dr. Ahmed Bayoumi was supported by a Canadian Institutes of Health Research/Ontario Ministry of Health and Long-Term Care Applied Chair in Health Services and Policy Research. The Centre for Research on Inner City Health is supported in part by a grant from the Ontario Ministry of Health and Long-Term Care. The views expressed in this article are those of the authors, and no official endorsement by supporting agencies is intended or should be inferred.

Appendix 1. Sensibility Questionnaire (adults living with HIV)

You have just completed the HIV Disability Questionnaire. The goal of the questionnaire is to describe disability experienced by adults living with HIV. We would like to get your feedback on its use. Please circle the most appropriate numeric answer on the scale in response to each of the following statements pertaining to the HIV Disability Questionnaire.

Face Validity

1.	I was able to answer all of the questions.
2.	The instructions were clear and easy to understand.
3.	The questions were clear and easy to understand.
4.	The overall questionnaire makes sense.
5.	The response categories for the questions were adequate.

Content validity

6.	The HIV Disability Questionnaire was intended to capture disability which has been defined by adults living with HIV as: symptoms and impairments, difficulties with day-to-day activities, challenges to social inclusion and uncertainty. The questionnaire captured all elements of my disability.
7.	The instrument included important items that are necessary to describe my disability.
8.	The instrument included items that were repetitive or redundant.*
9.	There were items missing in this questionnaire that should be included.*
10.	Some of the questions seemed out of order.*
11.	I was able to find my answer in the list of possible answers to the questions.

Ease of usage

12.	I felt uncomfortable answering some of the questions because I did not want to have anyone know my answer.*
13.	I felt that the questions made me think about things that I would have preferred not to have thought about.*
14.	I felt that answering the questions helped me in some way.
15.	The questionnaire took too long for me to complete.*
16.	The survey required too much effort to complete.*
17.	This questionnaire is useful in describing disability experienced by adults living with HIV.

*items reversed scored.