The modified patient enablement instrument: a Portuguese cross-cultural adaptation, validity and reliability study

• Published in: NPJ primary care respiratory medicine 2017-01, Vol.27 (1), p.1-5, Article 16087
• Main Authors: Remelhe, Ana Mafalda Pedroso, Teixeira, Pedro Miguel Silva Costa Afonso, Lopes, Irene, Silva, Luis Felipe Martins da, Correia de Sousa, Jaime
• Format: Article
• Language: English
• Subjects: 692/1807; 692/308; Adult; Aged; Aged, 80 and over; Asthma - psychology; Asthma - therapy; Culturally Competent Care; Factor Analysis, Statistical; Female; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Pneumology/Respiratory System; Portugal; Primary Care Medicine; Psychometrics; Reproducibility of Results; Science & Technology; Self-Management - psychology; Surveys and Questionnaires; Thoracic Surgery; Translations; United Kingdom; Young Adult
• ISSN: 2055-1010; 2055-1010
• DOI: 10.1038/npjpcrm.2016.87

"Article number: 16087" Enabling patients with asthma to obtain the knowledge, confidence and skills they need in order to assume a major role in the management of their disease is cost effective. It should be an integral part of any plan for long-term control of asthma. The modified Patient Enablement Instrument (mPEI) is an easily administered questionnaire that was adapted in the United Kingdom to measure patient enablement in asthma, but its applicability in Portugal is not known. Validity and reliability of questionnaires should be tested before use in settings different from those of the original version. The purpose of this study was to test the applicability of the mPEI to Portuguese asthma patients after translation and cross-cultural adaptation, and to verify the structural validity, internal consistency and reproducibility of the instrument. The mPEI was translated to Portuguese and back translated to English. Its content validity was assessed by a debriefing interview with 10 asthma patients. The translated instrument was then administered to a random sample of 142 patients with persistent asthma. Structural validity and internal consistency were assessed. For reproducibility analysis, 86 patients completed the instrument again 7 days later. Item-scale correlations and exploratory factor analysis were used to assess structural validity. Cronbach's alpha was used to test internal consistency, and the intra-class correlation coefficient was used for the analysis of reproducibility. All items of the Portuguese version of the mPEI were found to be equivalent to the original English version. There were strong item-scale correlations that confirmed construct validity, with a one component structure and good internal consistency (Cronbach's alpha >0.8) as well as high test-retest reliability (ICC=0.85). The mPEI showed sound psychometric properties for the evaluation of enablement in patients with asthma making it a reliable instrument for use in research and clinical practice in Portugal. Further studies are needed to confirm its responsiveness. Financial support for this work was provided by FEDER funds through the Operational Programme Competitiveness Factors-COMPETE and National Funds through FCT-Foundation for Science and Technology under the project POCI-01-0145-FEDER-007038, and by the project NORTE-01-0145-FEDER-000013, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, throu