Cross-Cultural Adaptation and Reliability Testing of Chinese Version of the Living with Medicines Questionnaire in Elderly Patients with Chronic Diseases

Figures & data

Table 1 Demographic Characteristics of Participants (n=412)

Characteristics	n (%)
Age (years), mean±SD	72.95±7.294
Gender
Male	151 (36.7)
Female	261 (63.3)
Educational level
Primary school or less	110 (26.7)
Middle school	175 (42.5)
High school	94 (22.8)
College or above	31 (7.5)
Employment status
Retired	147 (35.7)
Employed	2 (0.5)
Unemployed	263 (63.8)
Primary caregiver
Spouse	194 (47.1)
Child	175 (42.5)
Care workers	2 (0.5)
No primary caregiver	41 (10.0)
Income per month (RMB)
<2000	137 (33.3)
2000–3000	108 (26.2)
>3000–4000	85 (20.6)
>4000	82 (19.8)
Living status
Lives with spouse only	205 (49.8)
Lives with children only	42 (10.2)
Lives with both spouse and children	122 (29.8)
Lives alone	42 (10.2)
Health conditions (diagnoses)
High blood pressure	352 (85.4)
Stroke	196 (47.6)
Diabetes	239 (58.0)
Hyperlipidaemia	252 (61.2)
Coronary heart disease	227 (55.1)
Skeletal muscle diseases	132 (32.0)
Other	67 (16.3)

Table 2 Goodness-of-Fit Indices for the LMQ-3 Factor Models

Index	Value	Reference Standard
RMSEA estimate	0.084	<0.05
X^2/df	3.913	1–2
Goodness of fit index (GFI)	0.730	>0.90
Normed-fit index (NFI)	0.795	>0.90
Adjusted GFI (AGFI)	0.687	>0.90
Comparative fit index (CFI)	0.838	>0.90

Table 3 Factor Structure of C-LMQ-3[¹⁸]

Item[^Citation18]	Derived factors
	Conc	Effec	Relat	Prac	Int	sideE	Auto	Cost
Attitudes/concern about medicine use α=0.924
I worry that I have to take several medicines at the same time	0.880
I would like more say in the brands of medicines I use	0.863
I feel I need more information about my medicines	0.836
I am concerned about possible damaging long term effects of taking medicines	0.842
I am concerned that I am too reliant on my medicines	0.694
I worry that my medicines may interact with each other	0.832
I am concerned that my medicines interact with eating habits (other food, alcohol, drinks, etc.)	0.660
Lack of effectiveness α=0.932
My medicines prevent my condition getting worse		0.781
My medicines live up to my expectations		0.863
My medicines allow me to live my life as I want to		0.865
My medicines are working		0.909
The side effects are worth it for the benefits I get from my medicines		0.912
Relationships and communication about medicines α=0.926
I trust the judgement of my doctor(s) in choosing medicines for me			0.785
My doctor(s) listen to my opinions about my medicines			0.814
My doctor(s) takes my concerns about side effects seriously			0.913
I get enough information about my medicines from my doctor(s)			0.930
The health professionals providing my care know enough about me and my medicines			0.863
Practical difficulties α=0.853
I find getting my prescriptions from the doctor difficult				0.864
I am comfortable with the times I should take my medicines				0.863
I am concerned that I may forget to take my medicines				0.729
It is easy to keep to my medicines routine				0.636
I find using my medicines difficult (eg, taking the medication from the package, keeping in mind the precautions for medication use, etc.)				0.807
I have to put a lot of planning and thought into taking my medicines				0.606
Interference to day-to-day life α=0.822
My medicines interfere with my social or leisure activities					0.721
My medicines interfere with my sexual life					0.613
Taking medicines affects my going out (walking, cycling, driving, etc.)					0.657
My medicines interfere with my social relationships with (family, friends, colleagues)					0.780
Taking medicines causes me problems with daily tasks (such as work, housework, hobbies)					0.786
My life revolves around using my medicines					0.678
Side effects burden α=0.912
The side effects I get are sometimes worse than the problem for which I take medicines						0.810
The side effects I get from my medicines interfere with my day-to-day life (eg. work, housework, sleep)						0.842
The side effects I get from my medicines are bothersome						0.782
The side effects I get from my medicines adversely affect my well-being						0.861
Autonomy/control α=0.897
I can vary the dose of the medicines I take							0.886
I can choose whether or not to take my medicines							0.869
I can vary the times I take my medicines							0.884
Cost-related burden α=0.878
I worry about paying for my medicines								0.807
I sometimes have to choose between buying basic essentials or medicines								0.843
I have to pay more than I can afford for my medicines								0.864
Eigenvalue	5.310	4.009	3.951	3.569	3.356	3.116	2.631	2.525
Cumulative variance	13.773	24.052	34.183	43.334	51.939	59.929	66.676	73.149

Notes: Katusiime B, Corlett S, Krska J. Development and validation of a revised instrument to measure burden of long-term medicines use: the Living with Medicines Questionnaire version 3. Patient Relat Outcome Meas. 2018;9:155–168. © University of Kent, 2020, all rights reserved.

Abbreviations: C-lMQ-3, Chinese version of Living with Medicines Questionnaire 3; Conc, general concerns about medicines; Effec, lack of effectiveness; Relat, patient–doctor relationships and communication about medicines; Int, interferences with day-to-day life; Prac, practical difficulties; SideE, side effects; Cost, auto, lack of autonomy/control over medicine use, cost-related burden.

Table 4 Responses to Individual Statements in the C-LMQ-3 (n=412)[¹⁸]

Statements/Domains[^Citation18]	Agree/Strongly Agree N (%)	Neutral Opinion N (%)	Disagree/Strongly Disagree N (%)
Practical difficulties (6 items)
I find getting my prescriptions from the doctor difficult	64 (15.5)	101 (24.5)	247 (60.0)
I am comfortable with the times I should take my medicines	247 (60.0)	94 (22.8)	71 (17.2)
I am concerned that I may forget to take my medicines	61 (14.8)	97 (23.5)	254 (61.7)
It is easy to keep my medicines routine	219 (53.2)	130 (31.6)	63 (15.3)
I find using my medicines difficult (eg, taking the medication from the package, keeping in mind the precautions for medication use, etc.)	58 (14.1)	151 (36.7)	312 (75.7)
I have to put a lot of planning and thought into taking my medicines	75 (18.2)	190 (46.1)	147 (35.7)
Lack of effectiveness (5 items)
My medicines prevent my condition getting worse	148 (35.9)	121 (29.4)	143 (34.7)
My medicines live up to my expectations	162 (39.3)	119 (28.9)	131 (31.8)
My medicines allow me to live my life as I want to	147 (35.7)	127 (30.8)	138 (33.5)
My medicines are working	119 (28.9)	153 (37.1)	140 (34.0)
The side effects are worth it for the benefits I get from my medicines	120 (29.1)	152 (36.9)	140 (34.0)
Cost-related burden (3 items)
I worry about paying for my medicines	227 (55.1)	36 (8.7)	149 (36.1)
I sometimes have to choose between buying basic essentials or medicines	185 (44.9)	127 (30.8)	100 (24.3)
I have to pay more than I can afford for my medicines	209 (50.7)	59 (14.3)	144 (35.0)
Communication/relationships with HCPs (5 items)
I trust the judgement of my doctor(s) in choosing medicines for me	279 (67.7)	71 (17.2)	62 (15.1)
My doctor(s) listen to my opinions about my medicines	236 (57.3)	78 (18.9)	98 (23.8)
My doctor takes my concerns about side effects seriously	182 (44.2)	151 (36.7)	79 (19.2)
I get enough information about my medicines from my doctor(s)	176 (42.7)	152 (36.9)	84 (20.4)
The health professionals providing my care know enough about me and my medicines	203 (49.3)	132 (32)	77 (18.7)
Concerns about medicine use (7 items)
I worry that I have to take several medicines at the same time	213 (51.7)	12 (2.9)	187 (45.4)
I would like more say in the brands of medicines I use	187 (35.4)	43 (10.4)	182 (44.2)
I feel I need more information about my medicines	242 (58.7)	24 (5.8)	146 (35.5)
I am concerned about possible damaging long-term effects of taking medicines	242 (58.7)	28 (6.8)	142 (34.3)
I am concerned that I am too reliant on my medicines	232 (56.3)	27 (6.6)	153 (37.1)
I am concerned that my medicines interact with eating habits (other food, alcohol, drinks, etc.)	147 (35.7)	141 (34.2)	124 (30.1)
I worry that my medicines may interact with each other	109 (26.5)	126 (30.6)	177 (43)
Side-effect-burden (4 items)
The side effects I get are sometimes worse than the problems for which I take my medicines	114 (27.7)	126 (30.6)	172 (41.7)
The side effects that I get from my medicines interfere with my day-to-day life	101 (24.5)	106 (25.7)	205 (49.8)
The side effects I get from my medicines are bothersome	111 (26.9)	115 (28.0)	186 (45.1)
The side effects I get from my medicines adversely affect my wellbeing	108 (26.2)	116 (28.2)	188 (45.6)
Interference to day-to-day life (6 items)
My medicines interfere with my social or leisure activities	177 (42.9)	126 (30.6)	109 (26.5)
Taking medicines affects my going out (walking, cycling, driving, etc.)	193 (46.8)	138 (33.5)	81 (19.7)
My medicines interfere with my social relationships with (family, friends, colleagues)	190 (46.1)	133 (32.3)	89 (21.6)
Taking medicines causes problems with daily tasks	158 (38.3)	158 (38.3)	96 (23.4)
My medicines interfere with my sexual life	109 (26.5)	258 (62.6)	45 (10.9)
My life revolves around using medicines	177 (43.0)	197 (47.8)	38 (9.2)
Autonomy/control (3 items)
I can vary the dose of the medicines I take	226 (54.9)	80 (19.4)	106 (25.7)
I can choose whether or not to take my medicines	243 (59.1)	69 (16.7)	100 (24.2)
I can vary the times I take my medicines	224 (54.4)	87 (21.1)	101 (24.5)

Katusiime B, Corlett S, Krska J. Development and validation of a revised instrument to measure burden of long-term medicines use: the Living with Medicines Questionnaire version 3. Patient Relat Outcome Meas. 2018;9:155–168.

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