Elaboration and validation of a questionnaire assessing patient expectations about management of knee osteoarthritis by their physicians: the Knee Osteoarthritis Expectations Questionnaire
- Mathilde Benhamou1,
- Isabelle Boutron2,
- Marie Dalichampt2,
- Gabriel Baron2,
- Sophie Alami3,
- François Rannou1,4,
- Philippe Ravaud2,
- Serge Poiraudeau1,4
- 1AP-HP, Service de Rééducation et Réadaptation de l'appareil Locomoteur et des Pathologies du Rachis, Université Paris Descartes, INSERM IFR 25 Handicap, Paris, France
- 2AP-HP, Centre d'Epidémiologie Clinique, Université Paris Descartes, Paris, France
- 3Université Paris Descartes, Interlis, Paris, France
- 4Section Arthrose de la Société Française de Rhumatologie, Paris, France
- Correspondence to Serge Poiraudeau, Service de Rééducation et de Réadaptation de l'appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France;
Contributors MB, IB, FR, PR and SP conceived the study design. IB, MD, GB and PR performed the statistical analysis. MB and SP wrote the first draft of the manuscript. All authors approved the final draft of the manuscript.
- Received 20 December 2011
- Accepted 9 April 2012
- Published Online First 6 May 2012
Objectives To develop a questionnaire assessing the expectations of patients regarding management of osteoarthritis (OA of the knee.
Methods A detailed document reporting on a qualitative analysis of interviews of patients with knee OA was sent to experts and a Delphi procedure was adopted for item generation. Eighty physicians (64 general practitioners, 16 rheumatologists) recruited 566 patients with knee OA to test the provisional questionnaire. Items were reduced according to their metric properties and exploratory factor analysis. The reliability of the questionnaire was tested by the Cronbach α coefficient. Construct validity was tested by divergent validity and confirmatory factor analysis. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC) and the Bland–Altman technique.
Results Sixty items were extracted from analysis of the interview data. The experts needed three Delphi rounds to obtain consensus on a 33-item provisional questionnaire. The item reduction process resulted in an 18-item questionnaire. Exploratory factor analysis extracted three main factors: factor 1 represented expectations for education, factor 2 expectations for information on technical and human support, and factor 3 expectations for physician empathy. The Cronbach α coefficient was 0.91 (95% CI 0.89 to 0.92). Expected divergent validity was observed. Confirmation factor analyses confirmed higher intra-factor than inter-factor correlations. Test–retest reliability was good with an ICC of 0.79, and Bland–Altman analysis did not reveal a systematic trend.
Conclusions A new 18-item questionnaire assessing patient expectations of management of knee OA by their physicians is proposed. The questionnaire has good content and construct validity.
Funding Pfizer France.
Competing interests None.
Patient consent Obtained.
Ethics approval The study protocol was approved by the ethics committee of Cochin Hospital, Paris. Investigations were conducted according to the principles of the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.