Development of a new occupational balance-questionnaire: incorporating the perspectives of patients and healthy people i
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RESEARCH
Open Access
Development of a new occupational balancequestionnaire: incorporating the perspectives of patients and healthy people in the design of a self-reported occupational balance outcome instrument Mona Dür1, Günter Steiner1, Veronika Fialka-Moser2, Alexandra Kautzky-Willer3, Clemens Dejaco4, Birgit Prodinger5, Michaela Alexandra Stoffer1, Alexa Binder6, Josef Smolen1,7 and Tanja Alexandra Stamm1,8*
Abstract Background: Self-reported outcome instruments in health research have become increasingly important over the last decades. Occupational therapy interventions often focus on occupational balance. However, instruments to measure occupational balance are scarce. The aim of the study was therefore to develop a generic self-reported outcome instrument to assess occupational balance based on the experiences of patients and healthy people including an examination of its psychometric properties. Methods: We conducted a qualitative analysis of the life stories of 90 people with and without chronic autoimmune diseases to identify components of occupational balance. Based on these components, the Occupational Balance-Questionnaire (OB-Quest) was developed. Construct validity and internal consistency of the OB-Quest were examined in quantitative data. We used Rasch analyses to determine overall fit of the items to the Rasch model, person separation index and potential differential item functioning. Dimensionality testing was conducted by the use of t-tests and Cronbach’s alpha. Results: The following components emerged from the qualitative analyses: challenging and relaxing activities, activities with acknowledgement by the individual and by the sociocultural context, impact of health condition on activities, involvement in stressful activities and fewer stressing activities, rest and sleep, variety of activities, adaptation of activities according to changed living conditions and activities intended to care for oneself and for others. Based on these, the seven items of the questionnaire (OB-Quest) were developed. 251 people (132 with rheumatoid arthritis, 43 with systematic lupus erythematous and 76 healthy) filled in the OB-Quest. Dimensionality testing indicated multidimensionality of the questionnaire (t = 0.58, and 1.66 after item reduction, non-significant). The item on the component rest and sleep showed differential item functioning (health condition and age). Person separation index was 0.51. Cronbach’s alpha changed from 0.38 to 0.57 after deleting two items. (Continued on next page)
* Correspondence: [email protected] 1 Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria 8 Department of Health, University of Applied Sciences, FH Campus Wien, Favoritenstraße 226, Vienna 1100, Austria Full list of author information is available at the end of the article © 2014 Dür et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License
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