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A new measure of multimorbid illness and treatment representations: the example of diabetes and depression

A new measure of multimorbid illness and treatment representations: the example of diabetes and depression
A new measure of multimorbid illness and treatment representations: the example of diabetes and depression
Background
Depression is two to three times more common in people with diabetes than in the general population. Although multimorbid diabetes and depression is associated with poor health outcome, existing research has focused on patients? understanding and management of each condition in isolation. This study describes the development and validation of the Diabetes and Depression Representation and Management Questionnaire (DDRMQ), a measure of understanding, management and medication beliefs in people with diabetes and depression.

Methods
In Study 1, DDRMQ items were developed through further analysis of an earlier qualitative study and refined through 18 cognitive interviews. In Study 2, 334 adults with diabetes and depression from general practices, diabetes clinics and support groups completed the DDRMQ, demographic questions and validating measures.

Results
Factor analysis of the DDRMQ using principal axis factoring resulted in a 35 item scale organised into ten subscales. The modified measure had adequate internal and test–retest reliability. Initial evidence of construct validity was also demonstrated.

Limitations
Low participant response rates and the high percentage of well-educated white participants limit the generalisability of results. As Study 2 was cross-sectional, future research is needed to establish if different ways of thinking about and managing diabetes and depression can predict patient outcome.

Conclusions
The DDRMQ is the first measure of patient understanding, management and medication beliefs in people with established diagnoses of both diabetes and depression. The DDRMQ will facilitate an increased awareness of the patient experience of diabetes and depression and help inform patient centred care and intervention development for people with multiple conditions.
diabetes, depression, illness beliefs, multimorbidity, questionnaire, self-management
0165-0327
192-200
Mc Sharry, Jennifer
26f44a18-8edd-4a74-ad29-96b1ac0db9aa
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Mc Sharry, Jennifer
26f44a18-8edd-4a74-ad29-96b1ac0db9aa
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5

Mc Sharry, Jennifer, Bishop, Felicity L., Moss-Morris, Rona, Holt, Richard I.G. and Kendrick, Tony (2015) A new measure of multimorbid illness and treatment representations: the example of diabetes and depression. Journal of Affective Disorders, 174, 192-200. (doi:10.1016/j.jad.2014.11.050). (PMID:25506756)

Record type: Article

Abstract

Background
Depression is two to three times more common in people with diabetes than in the general population. Although multimorbid diabetes and depression is associated with poor health outcome, existing research has focused on patients? understanding and management of each condition in isolation. This study describes the development and validation of the Diabetes and Depression Representation and Management Questionnaire (DDRMQ), a measure of understanding, management and medication beliefs in people with diabetes and depression.

Methods
In Study 1, DDRMQ items were developed through further analysis of an earlier qualitative study and refined through 18 cognitive interviews. In Study 2, 334 adults with diabetes and depression from general practices, diabetes clinics and support groups completed the DDRMQ, demographic questions and validating measures.

Results
Factor analysis of the DDRMQ using principal axis factoring resulted in a 35 item scale organised into ten subscales. The modified measure had adequate internal and test–retest reliability. Initial evidence of construct validity was also demonstrated.

Limitations
Low participant response rates and the high percentage of well-educated white participants limit the generalisability of results. As Study 2 was cross-sectional, future research is needed to establish if different ways of thinking about and managing diabetes and depression can predict patient outcome.

Conclusions
The DDRMQ is the first measure of patient understanding, management and medication beliefs in people with established diagnoses of both diabetes and depression. The DDRMQ will facilitate an increased awareness of the patient experience of diabetes and depression and help inform patient centred care and intervention development for people with multiple conditions.

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More information

Accepted/In Press date: 25 November 2014
e-pub ahead of print date: 3 December 2014
Published date: 15 March 2015
Keywords: diabetes, depression, illness beliefs, multimorbidity, questionnaire, self-management
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 372999
URI: http://eprints.soton.ac.uk/id/eprint/372999
ISSN: 0165-0327
PURE UUID: 7bc4002a-670c-4f3f-97cb-89daf10b6652
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Richard I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

Catalogue record

Date deposited: 06 Jan 2015 10:08
Last modified: 15 Mar 2024 03:15

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Contributors

Author: Jennifer Mc Sharry
Author: Rona Moss-Morris
Author: Tony Kendrick ORCID iD

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