Development of an item pool for a questionnaire on the psychosocial consequences of hypertension labelling

Abstract

Background: Hypertension is the most prevalent risk factor for cardiovascular disease globally. Roughly one-third of the adult population has hypertension. However, most people diagnosed with hypertension do not benefit from blood pressure control with pharmacologic interventions: they are overdiagnosed and overtreated and might experience negative psychosocial consequences of being labelled. These consequences are relevant outcomes that need to be assessed and validly measured to identify all benefits and harms related to interventions designed to prevent cardiovascular disease. Objectives: To develop a pool of items with high content validity for a draft version of a condition-specific questionnaire to measure the psychosocial consequences of being labelled with mild hypertension. Methods: We selected relevant items from existing Consequences of Screening (COS) questionnaires. These items belonged to two groups: COS core items and potential condition-specific items. All items were originally in Danish and were translated into Brazilian Portuguese using the dual-panel method. Individual and group interviews were conducted with people with mild hypertension and low risk for cardiovascular disease, and were designed to test the translated items for face and content validity and were also used to generate new relevant items. Structured individual interviews were conducted to categorise all the items into domains. Results: The Brazilian Portuguese dual-panel translation of both groups of items was found to be relevant for adults diagnosed with hypertension. We generated 52 new items to achieve high content validity. The result was a set of 132 items divided into 22 domains in 2 parts. Part I was directed at the general population, whereas part II was directed only at people diagnosed with hypertension and it consisted of 38 items in 8 domains. Twelve items remained as single items. High content validity was achieved with the pool of 132 items divided into 22 domains in 2 parts. Discussion: High content validity was achieved for a condition-specific questionnaire measuring the psychosocial consequences of being labelled with mild hypertension. This instrument encompassed 132 items divided into 22 domains in 2 parts. Thereby, a draft of the Consequneces of Hypertension questionnaire (COH) was developed. The psychometric properties of this questionnaire will be discussed in a diferent paper.

Psychometric properties of a condition-specific PROM for the psychosocial consequences of Labelling hypertension by using Rasch analysis

“…A previous qualitative assessment of the psychosocial consequences of labelling hypertension described the diagnosis of hypertension as a labelling event with potential unintended negative long-term psychosocial consequences (here assumed to be the same as negative effects of labelling) [ 11 ]. Similar results are confirmed by our research group in our study population [ 12 ].…”

“…The subscale ‘relations negative’ strengthens the social aspects of the psychosocial consequences of labelling, whereas the subscale ‘patient role’ strengthens the labelling effects, suggesting that the labelled people develop actions and attitudes expected from the labelled condition. These relevant aspects are found in the qualitative content analysis of our previous study [ 12 ].…”

“…We previously developed a Brazilian Portuguese pool of items aiming for the psychosocial consequences of labelling hypertension (Table 1 ) [ 12 ]. That is, we translated items from all versions of the Danish Consequences of Screening (COS) questionnaires [ 25 – 28 ] to Brazilian Portuguese.…”

Reporting of patient involvement: a mixed-methods analysis of current practice in health research publications using a targeted search strategy

“…Initially, we did not plan to exclude publications applying qualitative research methods. However, we did not find a clear definition to differentiate between the active involvement of stakeholders and their involvement as participants in qualitative research, for example, in focus groups or interview studies 23–26. In some cases, both were reported in the same publication 23.…”

Reporting of patient involvement: A mixed-methods analysis of current practice in health research publications

“…However, we did not find a clear definition to differentiate between the active involvement of stakeholders and their involvement as participants in qualitative research, for example in focus groups or interview studies. [e.g., [33][34][35] In some cases, both were reported in the same publication. [e.g., 33] This particular challenge has previously been noted in the context of assessing reporting of patient and public involvement.…”