Background
Methods
Translation and cultural adaptation
Psychometric analyses of the Dutch heiQ
Design and procedure
Population
Sample size estimation
Psychometric parameters and thresholds
Data analyses
Results
Acceptability and comprehensibility of the Dutch translation
Psychometric analyses
Participants
Food allergy (FA) | Atopic dermatitis (AD) | Rheumatoid arthritis (RA) | Asthma | Total | |
---|---|---|---|---|---|
n
| 66 | 71 | 88 | 61 | 286 |
Sex: Female n (%) | (77.3) | (64.8) | (69.3) | (83.3) | (72%) |
Age: mean, (sd) in years | 36.0 (12.5) | 34.9 (15.3) | 53.6 (15.1) | 42.5 (13.7) | 42.5 (16.3) |
Other demographic data (n) | 14 | 18 | 88 | n.a. | 120 |
Marital status | |||||
Single | 50% | 33% | 14% | 21% | |
Married | 50% | 61% | 75% | 70% | |
Divorced | 0% | 0% | 9% | 7% | |
Widowed | 0% | 6% | 2% | 3% | |
Level of educationa
| |||||
Low | 14% | 11% | 33% | 28% | |
Medium | 21% | 22% | 32% | 29% | |
High | 64% | 67% | 32% | 41% | |
Other | 0% | 0% | 3% | 3% | |
Duration of disease mean (sd) in years | 15.8 (11.7) | 27.3 (14.8) | 13.3 (11.8) | 15.7 (13.1) | |
Self-rated health score mean (sd)c
| 7.1 (1.4) | 7.3 (1.2) | 6.5 (1.6) | 6.7 (1.6) | |
Asthma Control Questionnaire (ACQ) (sd)d
| 1.0 (0.8) | ||||
Food allergy characteristicsb
| |||||
Peanut | 50% | ||||
Nuts | 73% | ||||
Egg | 12% | ||||
Cow’s milk | 15% | ||||
Other animal products | 11% | ||||
Fruits & vegetables | 68% |
Confirmatory factor analysis
CFI | RMSEA | WRMR | TLI | Chi-square of Model Fit | |||
---|---|---|---|---|---|---|---|
Value | DF |
P
| |||||
One factor models | |||||||
Health directed activity | 1.00 | 0.06 | 0.32 | 1.00 | 3.92 | 2.00 | 0.14 |
Positive and active engagement in life | 0.97 | 0.15 | 0.94 | 0.95 | 38.57 | 5.00 | 0.00 |
additional analysis: heiQ15 WITH heiQ8; |
1.00
|
0.07
|
0.44
|
1.00
|
10.28
|
4.00
|
0.04
|
Emotional distress | 0.99 | 0.10 | 0.70 | 0.99 | 36.21 | 9.00 | 0.00 |
additional analysis: heiQ12 WITH heiQ4; |
1.00
|
0.09
|
0.56
|
0.99
|
25.20
|
8.00
|
0.00
|
Self-monitoring and insight | 0.87 | 0.16 | 1.28 | 0.78 | 75.91 | 9.00 | 0.00 |
additional analysis:
heiQ17 WITH heiQ3; heiQ11 WITH heiQ6; |
0.99
|
0.06
|
0.49
|
0.98
|
13.01
|
7.00
|
0.07
|
Constructive attitudes and approaches | 1.00 | 0.06 | 0.38 | 1.00 | 9.70 | 5.00 | 0.08 |
Skill and technique acquisition | 1.00 | 0.08 | 0.30 | 0.99 | 5.80 | 2.00 | 0.05 |
Social integration and support | 0.98 | 0.15 | 0.82 | 0.97 | 38.35 | 5.00 | 0.00 |
additional analysis heiQ31 WITH heiQ28; heiQ35 WITH heiQ28; |
1.00
|
0.04
|
0.27
|
1.00
|
4.46
|
3.00
|
0.22
|
Health service navigation | 0.98 | 0.18 | 1.03 | 0.97 | 48.82 | 5.00 | 0.00 |
additional analysis heiQ33 WITH heiQ32 |
1.00
|
0.09
|
0.47
|
0.99
|
12.97
|
4.00
|
0.01
|
Eight-factor model | 0.89 | 0.05 | 0.064 | 0.88 | 1257.77 | 712 | 0.00 |
Item Difficulty (D) | 95% Confidence interval around D | Item remainder correlation C | 95% Confidence interval around C | Standardized factor loadings original model | Standardized factor loadings modified modela
| 95% CI for factor loadings b
| |
---|---|---|---|---|---|---|---|
Health-directed activity | |||||||
heiQ1 | 0.83 | 0.78–0.87 | 0.74 | 0.69–0.78 | 0.83 | 0.78–0.89 | |
heiQ9 | 0.76 | 0.71–0.81 | 0.67 | 0.61–0.72 | 0.78 | 0.72–0.84 | |
heiQ13 | 0.73 | 0.68–0.78 | 0.78 | 0.74–0.81 | 0.90 | 0.86–0.95 | |
heiQ19 | 0.65 | 0.59–0.70 | 0.58 | 0.51–0.64 | 0.67 | 0.59–0.74 | |
Positive and active engagement in life | |||||||
heiQ2 | 0.85 | 0.80–0.88 | 0.66 | 0.60–0.72 | 0.78 |
0.79
|
0.72–0.86
|
heiQ5 | 0.97 | 0.95–0.99 | 0.65 | 0.56–0.72 | 0.75 |
0.77
|
0.68–0.86
|
heiQ8 | 0.83 | 0.78–0.87 | 0.68 | 0.61–0.73 | 0.79 |
0.70
|
0.62–0.78
|
heiQ10 | 0.87 | 0.82–0.90 | 0.73 | 0.66–0.78 | 0.84 |
0.88
|
0.82–0.94
|
heiQ15 | 0.82 | 0.77–0.86 | 0.60 | 0.54–0.65 | 0.71 |
0.61
|
0.52–0.70
|
Emotional distress | |||||||
heiQ4 | 0.40 | 0.34–0.46 | 0.66 | 0.59–0.72 | 0.73 |
0.69
|
0.63–0.76
|
heiQ7 | 0.13 | 0.10–0.18 | 0.66 | 0.61–0.71 | 0.71 |
0.71
|
0.65–0.78
|
heiQ12 | 0.25 | 0.21–0.31 | 0.81 | 0.78–0.85 | 0.88 |
0.86
|
0.82–0.90
|
heiQ14 | 0.15 | 0.12–0.20 | 0.81 | 0.78–0.84 | 0.90 |
0.90
|
0.87–0.94
|
heiQ18 | 0.08 | 0.05–0.12 | 0.83 | 0.79–0.86 | 0.91 |
0.91
|
0.88–0.94
|
heiQ21 | 0.12 | 0.09–0.16 | 0.82 | 0.79–0.85 | 0.91 |
0.91
|
0.88–0.94
|
Self–monitoring and insight | |||||||
heiQ3 | 0.82 | 0.77–0.86 | 0.35 | 0.26–0.44 | 0.52 |
0.33
|
0.20–0.46
|
heiQ6 | 0.76 | 0.71–0.81 | 0.43 | 0.33–0.51 | 0.52 |
0.48
|
0.38–0.58
|
heiQ11 | 0.94 | 0.91–0.97 | 0.47 | 0.39–0.55 | 0.55 |
0.51
|
0.38–0.64
|
heiQ16 | 0.76 | 0.71–0.81 | 0.76 | 0.71–0.81 | 0.67 |
0.74
|
0.66–0.81
|
heiQ17 | 0.90 | 0.86–0.93 | 0.75 | 0.69–0.80 | 0.71 |
0.60
|
0.52–0.68
|
heiQ20 | 0.87 | 0.83–0.91 | 0.49 | 0.39–0.57 | 0.64 |
0.70
|
0.62–0.78
|
Constructive attitude and approaches | |||||||
heiQ27 | 0.96 | 0.93–0.98 | 0.75 | 0.68–0.80 | 0.84 | 0.80–0.88 | |
heiQ34
| 0.92 | 0.88–0.95 | 0.74 | 0.70–0.78 | 0.84 | 0.79–0.88 | |
heiQ36 | 0.91 | 0.87–0.94 | 0.77 | 0.74–0.80 | 0.87 | 0.83–0.91 | |
heiQ39 | 0.92 | 0.88–0.94 | 0.79 | 0.75–0.83 | 0.90 | 0.86–0.93 | |
heiQ40 | 0.90 | 0.85–0.93 | 0.59 | 0.54–0.64 | 0.67 | 0.60–0.74 | |
Skill and technique acquisition | |||||||
heiQ23 | 0.69 | 0.63–0.74 | 0.62 | 0.57–0.67 | 0.71 | 0.64–0.77 | |
heiQ25 | 0.84 | 0.79–0.88 | 0.78 | 0.73–0.83 | 0.93 | 0.90–0.96 | |
heiQ26 | 0.86 | 0.81–0.89 | 0.72 | 0.67–0.77 | 0.84 | 0.80–0.89 | |
heiQ30 | 0.80 | 0.75–0.85 | 0.66 | 0.62–0.70 | 0.77 | 0.71–0.84 | |
Social integration and support | |||||||
heiQ22 | 0.89 | 0.85–0.92 | 0.72 | 0.68–0.76 | 0.80 |
0.77
|
0.72–0.83
|
heiQ28 | 0.83 | 0.78–0.87 | 0.69 | 0.63–0.73 | 0.79 |
0.89
|
0.82–0.95
|
heiQ31 | 0.71 | 0.66–0.76 | 0.68 | 0.62–0.74 | 0.80 |
0.83
|
0.78–0.88
|
heiQ35 | 0.91 | 0.87–0.94 | 0.77 | 0.73–0.80 | 0.86 |
0.88
|
0.84–0.92
|
heiQ37 | 0.83 | 0.78–0.87 | 0.72 | 0.68–0.76 | 0.79 |
0.76
|
0.70–0.82
|
Health service navigation | |||||||
heiQ24 | 0.92 | 0.88–0.95 | 0.73 | 0.67–0.78 | 0.86 |
0.87
|
0.82–0.92
|
heiQ29 | 0.91 | 0.87–0.94 | 0.69 | 0.64–0.73 | 0.77 |
0.79
|
0.73–0.84
|
heiQ32 | 0.96 | 0.93–0.98 | 0.69 | 0.63–0.74 | 0.79 |
0.70
|
0.62–0.77
|
heiQ33 | 0.92 | 0.88–0.94 | 0.72 | 0.69–0.74 | 0.85 |
0.78
|
0.72–0.84
|
heiQ38 | 0.87 | 0.83–0.91 | 0.76 | 0.71–0.81 | 0.86 |
0.89
|
0.85–0.93
|
Item difficulty, item remainder correlation and reliability
Composite reliability a
| Confidence Interval | Intra class Correlation (n = 93) | 95% Confidence Interval Lower Bound - Upper Bound | |
---|---|---|---|---|
Health directed activity | 0.82 | 0.79–0.86 | 0.84 | 0.77–0.89 |
Positive and active engagement in life | 0.81 | 0.78–0.85 | 0.74 | 0.63–0.82 |
Emotional distress | 0.89 | 0.87–0.91 | 0.86 | 0.80–0.91 |
Self-monitoring and insight | 0.67 | 0.61–0.73 | 0.61 | 0.47–0.73 |
Constructive attitudes and approaches | 0.86 | 0.83–0.89 | 0.69 | 0.57–0.78 |
Skill and technique acquisition | 0.82 | 0.78–0.85 | 0.67 | 0.55–0.77 |
Social integration and support | 0.85 | 0.83–0.88 | 0.73 | 0.62–0.81 |
Health service navigation | 0.85 | 0.82–0.88 | 0.65 | 0.52–0.75 |
Comparison of the Dutch heiQ (NL) with the German (G), English (ENG), English revised (ENG-R) and French heiQ translations
Comparison of confirmatory factor analyses across language versions
Comparison of composite reliability across language versions
Dutch | German | English (original)c
| English (revised) | |
---|---|---|---|---|
Health directed activity | 0.82 | 0.83 | 0.80 | 0.83 |
Positive and active engagement in life | 0.81 | 0.75 | 0.86 | 0.83 |
Emotional distress | 0.89 | 0.88 | 0.89 | 0.86 |
Self-monitoring and insight a
| 0.67 | 0.74 | 0.70a
| 0.74 |
Constructive attitude and approaches | 0.86 | 0.87 | 0.81 | 0.88 |
Skills and techniques acquisitionb
| 0.82 | 0.77 | 0.81b
| 0.80 |
Social integration and support | 0.85 | 0.88 | 0.86 | 0.88 |
Health service navigation | 0.85 | 0.87 | 0.82 | 0.85 |
Comparison of eight factor models across language versions
CFA model | CFI | TLI | RMSEA |
---|---|---|---|
Dutch | 0.89 | 0.88 | 0.05 |
German | 0.92 | n.a | 0.04 |
English | 0.99 | n.a | 0.04 |
French | 0.92 | 0.91 | 0.04 |
Comparison of Intra Class Correlation (ICC) across language versions
Dutch
N = 93 | German
N = 69 | |
---|---|---|
Health directed activity | 0.84 | 0.60 |
Positive and active engagement in life | 0.74 | 0.72 |
Emotional distress | 0.86 | 0.77 |
Self-monitoring and insight | 0.61 | 0.63 |
Constructive attitude and approaches | 0.69 | 0.77 |
Skills and techniques acquisition | 0.67 | 0.72 |
Social integration and support | 0.73 | 0.83 |
Health service navigation | 0.65 | 0.68 |