SAT0652 VALIDATION OF A RISK PERCEPTION QUESTIONNAIRE DEVELOPED FOR PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Irazú Contreras-Yáñez, Pilar Lavielle, Patricia Clark, Virginia Dr. Pascual
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Risk perception (RP) is a multidimensional phenomenon that describes the individual's judgment of the likelihood of experiencing something unpleasant. RP shapes health-related-behaviors and may be central for rheumatoid arthritis (RA) management, where treatment must be based on shared decisions between the patient and the rheumatologist. Rheumatologists can motivate successful self-care in RA patients with information that brings the physician vision closer to the patient's perceptions. Assessing patients-perceived risk may help explain how RA patients integrate their ideas concerning the disease and its treatments, and how this understanding drives their self-care management. There is no current validated instrument to assess RP in RA. <h3>Objectives</h3> Develop and validated a RP-Questionnaire (RPQ) for Spanish speaking RA patients. <h3>Methods</h3> Development and validation the RPQ was performed in 3 different steps, using 3 different convenience samples of RA outpatients attending a tertiary-care-level center. The construction process suggested by Streiner for health measurement scales when a current measure does not exist was followed<sup>1</sup>. Step 1 was the conceptual model construction and included: a literature review, semi-structured one-to-one interviews to 20 RA outpatients which were directed to answer open-ended questions about the likelihood of harms related to RA, and interviews to 6 rheumatologists and 5 RA-experienced physiotherapists who were directed to list and rate (according to severity and frequency) 15 RA-related components (symptoms, manifestations and/or complications). Step 2 consisted of item generation (theory, patients interviews and expert opinions were the sources considered), item reduction performed in 100 additional RA patients (from 108 to 27 items, that were ultimately distributed into 5 dimensions following conceptual construction), scaling responses, item scoring and feasibility. Step 3 consisted of RPQ psychometric validation performed in 270 additional RA outpatients, content and face validity (by experts agreement), construct validity (exploratory factor analysis) and consistency and stability (Cronbach's α and test-retest). Validation sample size was based on the methodological recommendations, which suggested a minimum of 50 patients for assessing construct validity, 100 patients for assessing internal consistency, and 5 to 10 patients for each item. IRB approved the study. <h3>Results</h3> The 390 patients included in the 3 samples were representative of typical RA outpatients from a tertiary care level center; they were primarily women, in their fifth decade of life, with basic formal education, medium low socioeconomic status and had long-standing disease; in addition, patients with a major comorbid condition and with surgical joint replacement were also represented. RPQ included 27 items distributed in 5 factors (3 for likelihood, 1 for responsibility and prevention and 1 for disease control), which resulted in 68.8% of the variance explained. Cronbach's α for the total score was 0.90. Intraclass-correlation-coefficient in test-retest was 0.93 (95% CI=0.90-0.95). All items had ≥80% agreement from experts. Patients agreed about item's semantic clarity (89%) and RPQ format adequacy (97%). <h3>Conclusion</h3> RPQ showed to be a valid and reliable instrument to evaluate RP in Spanish speaking RA patients. RPQ can be incorporated to clinical care and guide interventions to improve patient's health behaviors. <h3>References</h3> [1] Steiner D, Norman G. (Eds). Health Measurement Scales. A practical guide to their development and use. New York. Oxford University. Press 2003. <h3>Disclosure of Interests</h3> None declared