Cross-cultural adaptation and psychometric properties of an Arabic language version of the Brief Illness Perception Questionnaire in Lebanon

Figures & data

Fig. 1 Procedure and stages of the assessment of the validity and reproducibility of the Arabic version of the Brief Illness Perception Questionnaire.

Table 1 Socio-demographic and disease/drug related characteristics of the participants (n=100)

Characteristics	Number (%)
Gender
Male	53 (53.0)
Female	47 (47.0)
Age (years)
<55	22 (22.0)
55−65	30 (30.0)
>65	47 (47.0)
Marital status
Single	20 (20.0)
Married	69 (69.0)
Divorced	4 (4.0)
Widowed	6 (6.0)
Missing data	1 (1.0)
Level of education
Primary	17 (17.0)
Secondary	45 (45.0)
University degree	36 (36.0)
Missing data	2 (2.0)
Type of cardiac disease
Hypertension	25 (25.0)
Heart failure	10 (10.0)
Cardiac arrhythmias	8 (8.0)
Cardiomyopathies	4 (4.0)
Ischemic heart disease or coronary  artery disease	21 (21.0)
More than one disease	32 (32.0)
Presence of concomitant non-cardiac diseases
No	22 (22.0)
Yes	78 (78.0)
Number of drugs taken by the patient^a
1	50 (50.0)
2	38 (38.0)
≥ 3	12 (12.0)
Number of drug intakes per day^a
1	36 (36.0)
2	51 (51.0)
≥ 3	13 (13.0)
Number of drug pills per day^a
1	34 (34.0)
2	43 (43.0)
3	12 (12.0)
≥ 4	11 (11.0)
Duration of treatment (months)^a	8.5±5.4

^aOnly drugs used to treat cardiac diseases are considered in this table.

Table 2 Percent distribution of the participants’ answers to each item of the Arabic version of the Brief Illness Perception Questionnaire

Consequences (How much does your illness affect your life?)
No affect at all	0	1	2	3	4	5	6	7	8	9	10 Severely affects
	25%	10%	10%	10%	4%	10%	5%	15%	7%	1%	3%
Timeline (How long do you think your illness will continue?)
A very short time	0	1	2	3	4	5	6	7	8	9	10 Forever
	25%	0%	1%	3%	3%	6%	6%	5%	8%	9%	58%
Personal control (How much control do you feel you have over your illness?)
Absolutely no control	0	1	2	3	4	5	6	7	8	9	10 Extreme control
	14%	2%	7%	13%	2%	20%	6%	16%	11%	4%	5%
Treatment control (How much do you think your treatment can help your illness?)
Not at all	0	1	2	3	4	5	6	7	8	9	10 Extremely helpful
	0%	0%	3%	2%	4%	14%	8%	21%	22%	10%	16%
Identity (How much do you experience symptoms from your illness?)
No symptoms at all	0	1	2	3	4	5	6	7	8	9	10 Many severe
	17%	5%	16%	17%	9%	13%	6%	9%	7%	1%	0%
Concern (How concerned are you about your illness?)
Not at all concerned	0	1	2	3	4	5	6	7	8	9	10 Extremely concerned
	20%	6%	12%	8%	8%	17%	5%	12%	6%	3%	3%
Understanding (How well do you feel you understand your illness?)
Don't understand	0	1	2	3	4	5	6	7	8	9	10 Very clearly
	3%	2%	6%	2%	3%	16%	4%	20%	19%	4%	21%
Emotional response (How much does your illness affect you emotionally: Makes you angry, scared, upset or depressed?)
Not affected	0	1	2	3	4	5	6	7	8	9	10 Extremely affected
	23%	5%	9%	10%	9%	12%	8%	15%	6%	0%	3%

Table 3 Internal consistency and reproducibility of the Arabic version of the Brief Illness Perception Questionnaire

Internal consistency
Cronbach's Alpha			No. of items
0.717			8
Item-total statistics	Scale mean if item deleted	Scale variance if item deleted	Corrected item-total correlation	Cronbach's alpha if item deleted
Consequence	25.64	116.576	0.574	0.649
Timeline	27.69	138.681	0.370	0.697
Personal control	24.05	144.573	0.153	0.743
Treatment control	26.39	141.614	0.377	0.697
Identity	25.67	128.728	0.504	0.670
Concern	25.30	119.444	0.560	0.653
Understanding	24.26	137.225	0.220	0.734
Emotional response	25.40	118.323	0.588	0.647
Reproducibility
		95% confidence interval
	Intra-class correlation	Lower bound	Upper bound	p
Consequence	0.981	0.960	0.991	<0.0001
Timeline	0.952	0.902	0.977	<0.0001
Personal control	0.955	0.907	0.979	<0.0001
Treatment control	0.776	0.580	0.887	<0.0001
Identity	0.938	0.874	0.970	<0.0001
Concern	0.964	0.926	0.983	<0.0001
Understanding	0.939	0.875	0.970	<0.0001
Emotional response	0.966	0.930	0.984	<0.0001

Table 4 Spearman's correlations between the Arabic version of the Brief Illness Perception Questionnaire (Brief IPQ-Ar) dimension scores and the global Brief IPQ-Ar score (n=100)

Dimension	p
Consequence	0.724^**
Timeline	0.520^**
Personal control	0.373^**
Treatment control	0.509^**
Identity	0.644^**
Concern	0.707^**
Understanding	0.451^**
Emotional response	0.727^**

**p-value (2-tailed) <0.001.

Table 5 Comparison of average scores among participants with different cardiac diseases for the eight dimensions of the Brief-IPQ

	Consequence	Timeline*	Personal control	Treatment control	Identity	Concern*	Understanding	Emotional response*
Hypertension (n=25)	3.08±3.265	7.68±3.185	4.24±3.257	7.28±2.031	2.88±2.315	2.84±2.853	6.00±2.930	3.12±2.934
Heart failure (n=10)	5.20±2.700	9.40±1.350	4.40±2.757	7.10±1.663	4.30±2.541	4.90±1.912	6.50±1.958	5.80±1.932
Cardiac arrhythmias (n=8)	3.38±2.387	7.00±2.330	4.12±2.642	7.50±2.390	3.75±2.866	5.50±1.927	6.62±3.021	4.12±2.748
Cardiomyopathies (n=4)	4.50±3.697	9.25±1.500	4.75±1.708	6.75±1.500	3.75±3.500	6.50±3.109	4.00±2.944	7.00±2.944
More than one disease (n=32)	3.12±3.056	9.06±1.703	5.25±2.828	6.66±2.336	3.94±2.675	3.69±3.146	7.50±2.110	3.47±3.037
Ischemic heart disease/coronary artery disease (n=21)	3.90±3.113	8.57±1.912	5.48±3.140	7.90±1.546	3.19±2.272	3.90±2.965	7.14±2.988	3.43±2.580

Kruskal-Wallis test; *p≤0.05.

Table 6 Spearman correlations between the Brief IPQ-Ar dimensions and level of education, treatment duration, and the number of pills ingested daily by the participants

	Level of education^† (n=98)	Treatment duration (n=100)	Number of pills/day (n=100)
Consequence	0.040	−0.063	0.200^*
Timeline	−0.058	0.307^**	0.048
Personal control	−0.005	−0.068	0.032
Treatment control	0.034	−0.106	−0.007
Identity	0.085	−0.053	0.262^**
Concern	0.209^*	−0.347^**	0.074
Understanding	0.053	−0.060	−0.084
Emotional response	0.112	−0.246^*	0.098

Spearman correlation; *p<0.05; **p<0.01; ^†missing values.