Patient Interpretation of Neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care

Loretta Vileikyte; Jeffrey S. Gonzalez; Howard Leventhal; Mark F. Peyrot; Richard R. Rubin; Adam Garrow; Jan S. Ulbrecht; Peter R. Cavanagh; Andrew J.M. Boulton

doi:10.2337/dc06-1550

Patient Interpretation of Neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care

Loretta Vileikyte, Jeffrey S. Gonzalez, Howard Leventhal, Mark F. Peyrot, Richard R. Rubin, Adam Garrow, Jan S. Ulbrecht, Peter R. Cavanagh, Andrew J.M. Boulton

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

Abstract

OBJECTIVE - Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. RESEARCH DESIGN AND METHODS - The Patient Interpretation of Neuropathy (PIN) questionnaire, generated from discussions with clinicians and interviews with patients with DPN, was administered to patients with DPN attending U.K. (n = 325) and U.S. (n = 170) diabetes centers. Psychometric tests of the PIN questionnaire comprised factor analysis, internal consistency, and test-retest reliability. Partial correlations and multivariate regressions established construct and criterion-related validity. The associations of PIN scales to past foot ulceration and foot self-care behaviors were compared with those using a generic measure of illness perception and emotion, the Revised Illness Perception Questionnaire (IPQ-R), which was adapted to neuropathy. RESULTS - Factor analysis of the PIN questionnaire produced 11 scales, which explained 69% of item variance. Nine factors measured patients' common-sense beliefs about DPN and their levels of understanding of DPN-related medical information. Two factors assessed the emotions of worry about potential consequences and anger at practitioners. Most scales demonstrated adequate internal (Cronbach's α = 0.62-0.90) and test-retest reliability (Pearson's r = 0.51-0.64). Partial correlations between the PIN and IPQ-R scales in corresponding domains were significant but modest (r_p = 0.15-0.26). Finally, PIN scales showed significant associations with past foot ulceration and foot self-care behaviors, thereby confirming criterion validity. CONCLUSIONS - The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.

Original language	English (US)
Pages (from-to)	2617-2624
Number of pages	8
Journal	Diabetes care
Volume	29
Issue number	12
DOIs	https://doi.org/10.2337/dc06-1550
State	Published - Dec 2006
Externally published	Yes

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

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Vileikyte, L., Gonzalez, J. S., Leventhal, H., Peyrot, M. F., Rubin, R. R., Garrow, A., Ulbrecht, J. S., Cavanagh, P. R., & Boulton, A. J. M. (2006). Patient Interpretation of Neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes care, 29(12), 2617-2624. https://doi.org/10.2337/dc06-1550

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title = "Patient Interpretation of Neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care",

abstract = "OBJECTIVE - Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. RESEARCH DESIGN AND METHODS - The Patient Interpretation of Neuropathy (PIN) questionnaire, generated from discussions with clinicians and interviews with patients with DPN, was administered to patients with DPN attending U.K. (n = 325) and U.S. (n = 170) diabetes centers. Psychometric tests of the PIN questionnaire comprised factor analysis, internal consistency, and test-retest reliability. Partial correlations and multivariate regressions established construct and criterion-related validity. The associations of PIN scales to past foot ulceration and foot self-care behaviors were compared with those using a generic measure of illness perception and emotion, the Revised Illness Perception Questionnaire (IPQ-R), which was adapted to neuropathy. RESULTS - Factor analysis of the PIN questionnaire produced 11 scales, which explained 69% of item variance. Nine factors measured patients' common-sense beliefs about DPN and their levels of understanding of DPN-related medical information. Two factors assessed the emotions of worry about potential consequences and anger at practitioners. Most scales demonstrated adequate internal (Cronbach's α = 0.62-0.90) and test-retest reliability (Pearson's r = 0.51-0.64). Partial correlations between the PIN and IPQ-R scales in corresponding domains were significant but modest (rp = 0.15-0.26). Finally, PIN scales showed significant associations with past foot ulceration and foot self-care behaviors, thereby confirming criterion validity. CONCLUSIONS - The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.",

author = "Loretta Vileikyte and Gonzalez, {Jeffrey S.} and Howard Leventhal and Peyrot, {Mark F.} and Rubin, {Richard R.} and Adam Garrow and Ulbrecht, {Jan S.} and Cavanagh, {Peter R.} and Boulton, {Andrew J.M.}",

year = "2006",

month = dec,

doi = "10.2337/dc06-1550",

language = "English (US)",

volume = "29",

pages = "2617--2624",

journal = "Diabetes care",

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T2 - An instrument for assessment of cognitive and emotional factors associated with foot self-care

AU - Vileikyte, Loretta

AU - Gonzalez, Jeffrey S.

AU - Leventhal, Howard

AU - Peyrot, Mark F.

AU - Rubin, Richard R.

AU - Garrow, Adam

AU - Ulbrecht, Jan S.

AU - Cavanagh, Peter R.

AU - Boulton, Andrew J.M.

PY - 2006/12

Y1 - 2006/12

N2 - OBJECTIVE - Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. RESEARCH DESIGN AND METHODS - The Patient Interpretation of Neuropathy (PIN) questionnaire, generated from discussions with clinicians and interviews with patients with DPN, was administered to patients with DPN attending U.K. (n = 325) and U.S. (n = 170) diabetes centers. Psychometric tests of the PIN questionnaire comprised factor analysis, internal consistency, and test-retest reliability. Partial correlations and multivariate regressions established construct and criterion-related validity. The associations of PIN scales to past foot ulceration and foot self-care behaviors were compared with those using a generic measure of illness perception and emotion, the Revised Illness Perception Questionnaire (IPQ-R), which was adapted to neuropathy. RESULTS - Factor analysis of the PIN questionnaire produced 11 scales, which explained 69% of item variance. Nine factors measured patients' common-sense beliefs about DPN and their levels of understanding of DPN-related medical information. Two factors assessed the emotions of worry about potential consequences and anger at practitioners. Most scales demonstrated adequate internal (Cronbach's α = 0.62-0.90) and test-retest reliability (Pearson's r = 0.51-0.64). Partial correlations between the PIN and IPQ-R scales in corresponding domains were significant but modest (rp = 0.15-0.26). Finally, PIN scales showed significant associations with past foot ulceration and foot self-care behaviors, thereby confirming criterion validity. CONCLUSIONS - The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.

AB - OBJECTIVE - Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. RESEARCH DESIGN AND METHODS - The Patient Interpretation of Neuropathy (PIN) questionnaire, generated from discussions with clinicians and interviews with patients with DPN, was administered to patients with DPN attending U.K. (n = 325) and U.S. (n = 170) diabetes centers. Psychometric tests of the PIN questionnaire comprised factor analysis, internal consistency, and test-retest reliability. Partial correlations and multivariate regressions established construct and criterion-related validity. The associations of PIN scales to past foot ulceration and foot self-care behaviors were compared with those using a generic measure of illness perception and emotion, the Revised Illness Perception Questionnaire (IPQ-R), which was adapted to neuropathy. RESULTS - Factor analysis of the PIN questionnaire produced 11 scales, which explained 69% of item variance. Nine factors measured patients' common-sense beliefs about DPN and their levels of understanding of DPN-related medical information. Two factors assessed the emotions of worry about potential consequences and anger at practitioners. Most scales demonstrated adequate internal (Cronbach's α = 0.62-0.90) and test-retest reliability (Pearson's r = 0.51-0.64). Partial correlations between the PIN and IPQ-R scales in corresponding domains were significant but modest (rp = 0.15-0.26). Finally, PIN scales showed significant associations with past foot ulceration and foot self-care behaviors, thereby confirming criterion validity. CONCLUSIONS - The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.

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JO - Diabetes care

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Patient Interpretation of Neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care

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