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Development and validation of IMAQ: Integrative Medicine Attitude Questionnaire.

ABSTRACT: Complementary/alternative medicine and integrative medicine (CAM/IM) are increasingly used in the U.S. We set out to develop and validate a brief questionnaire measuring health care provider and medical student attitudes regarding these approaches to healthcare.IMAQ is a 29-item, 7-point Likert scale rated instrument, developed from focus groups consisting of faculty, fellows, visiting residents, and medical students at a university based integrative medicine program. Respondents included 111 (of 574 contacted) internal medicine physicians on an academic medical center CME list and 85 healthcare providers (mostly physicians) attending an American Holistic Medical Association Annual Conference (296 attending). Cohorts were selected for expected differences in attitudes toward CAM/IM.Factor analysis demonstrated that a 2 factor solution best explained the variance in responses (38%). Factor 1 ("openness to new ideas and paradigms") explained 26% of variance with loadings ranging from 0.79 to 0.3, with factor 2 ("value of both introspection and relationship to patient") contributing an additional 12% of the explained variance with loadings ranging from 0.69 to 0.42. Both factors demonstrated adequate reliability. Factor 1 had a Cronbach's alpha of 0.91, while factor 2 was 0.72. As expected, AHMA conference attendees scored higher (F = 120.00, p < 0.001) than the internists on the IMAQ, supporting the construct validity. Although 63% of the AHMA subjects, and only 32% of the internists were female, analysis revealed that gender did not explain the score differences (F = 2.6, p > 0.05).Analysis of the IMAQ provided evidence of its reliability and validity in measuring attitudes toward CAM/IM, specifically openness to new ideas and paradigms, and the value of relationship to self and patient. Initial findings support use of the IMAQ in measuring attitudes of students and practitioners towards CAM/IM interventions as a first step in understanding willingness to use these approaches to healing. It is our desire that this preliminary instrument will continue to be refined as the field of CAM/IM matures.

SUBMITTER: Schneider CD

PROVIDER: S-EPMC200993 | biostudies-literature | 2003 Aug

REPOSITORIES: biostudies-literature

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Development and validation of IMAQ: Integrative Medicine Attitude Questionnaire.

Schneider Craig D CD Meek Paula M PM Bell Iris R IR

BMC medical education 20030828

<h4>Background</h4>Complementary/alternative medicine and integrative medicine (CAM/IM) are increasingly used in the U.S. We set out to develop and validate a brief questionnaire measuring health care provider and medical student attitudes regarding these approaches to healthcare.<h4>Methods</h4>IMAQ is a 29-item, 7-point Likert scale rated instrument, developed from focus groups consisting of faculty, fellows, visiting residents, and medical students at a university based integrative medicine p ...[more]

PMID: 12946276

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Project description:BackgroundMedical students should effectively manage conflicts in teamwork and communication with other team members. This study aimed to develop and validate a tool to evaluate attitude of medical students and physicians toward conflict management.MethodA multi-step process was employed to develop and validate a Conflict Management Attitude Questionnaire (CMAQ) based on the steps recommended in AMEE Guide No. 87. First, the initial items were obtained from the literature review and focus group. After cognitive interviews with the medical students and revision of the questionnaire, content validity was performed by experts. The construct validity and reliability of the questionnaire were assessed using exploratory Factor Analysis (EFA) and Cronbach's alpha coefficient, respectively.ResultsThis multi-step process resulted in a 12-item, five-point Likert-type questionnaire with satisfactory construct validity. Exploratory factor analysis revealed three factors, comprising the four items from the "perceived interactions in conflict management" subscale loading on the first factor, and five items from the "perceived value of learning conflict management" subscale loading on the second factor, along with three items from the "perceived application of conflict management" subscale loading on the third factor. All subscales described 56.48% of the variance. Validation results showed that Content Validity Index (CVI) and Content Validity Ratio (CVR) were greater than 0.75. Cronbach's alpha coefficient was 0.791.ConclusionThis study showed that CMAQ has valid evidence for assessing the attitude of medical students toward conflict management with favorable psychometric properties and strong evidence of construct validity. However, due to the lack of evidence on any specific questionnaire to evaluate the attitude towards conflict management, future studies should conduct a confirmatory investigation regarding other aspects of medical students' attitudes toward conflict management.

Project description:BackgroundChronic Kidney Disease (CKD) is a complex condition leading to loss of kidney function. The objective of this study was to develop and validate a Knowledge, Attitude, and Practice questionnaire on CKD (CKD-KAP) among practicing physicians in Pakistan since no validated tool was available for the said purpose.MethodsThe study consisted of four phases with phase-I focusing on literature review, phase II was the actual questionnaire development phase, face and content validity was determined in phase III, and finally pilot testing was performed in phase IV to determine validity and reliability. The development phase encompassed a thorough review of literature, focus-group discussion, expert review, and evaluation. The validation phase consisted of content validity, face validity, construct validity, convergent validity, and reliability. The pilot testing was performed by studying the KAP of 100 practicing physicians in tertiary care hospitals in Pakistan. The knowledge section of the validation phase utilized Item Response Theory (IRT) analysis. The attitude and practices sections utilized Exploratory Factor Analysis (EFA) theory. The reliability analysis utilized Cronbach's alpha and correlations.ResultsThe CKD-KAP questionnaire had three main sections: knowledge, attitude, and practice. During the validation, IRT analysis was performed on knowledge, which focused on the measure of the coefficient of discrimination and difficulty of the items; 40 out of 41 knowledge items have both discrimination and difficulty coefficients within an acceptable range. The EFA model was also fitted in the attitude and practices section, and scree plot and Eigenvalues suggested three and four dimensions within the attitude and practices section. The factor loading of all items was found to be acceptable except for one item in attitude which was deleted. The convergent validity demonstrated a significant association between all three sections except knowledge and practices. The reliability (internal consistency) analysis demonstrated Cronbach's alpha values above 0.7 and significant inter-item correlation. The final model of CKD-KAP had 40 knowledge, 13 attitude, and 10 practice items with a combination of both positive as well as negative questions and statements.ConclusionsThe CKD-KAP was found to be psychometrically valid and reliable, hence can be used to determine the knowledge, attitude, and practices of physicians toward chronic kidney disease.

Project description:Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM).Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS), which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50) from healthy individuals (n = 50) in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI) in undergraduate college students (N = 458). The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale) in a different sample of undergraduate students (N = 62).Substudy (i) Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50; controls r = 0.45). AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36; controls r = 0.50). Controls (r = 0.64) had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33), which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii) In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40). Substudy (iii) AIOS scores were significantly correlated with positive affect (rAIOS24h = 0.56, rAIOS1month = 0.57) and positive states of mind (rAIOS24h = 0.42, rAIOS1month = 0.45), and inversely correlated with negative affect (rAIOS24h = -0.41, rAIOS1month = -0.59).The AIOS is able to distinguish relatively sicker from relatively healthier individuals; and correlates in expected directions with a measure of distress and indicators of positive and negative affect and positive states of mind. The AIOS offers a tool for CAM/IM research that extends beyond a disease emphasis.

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Development and validation of IMAQ: Integrative Medicine Attitude Questionnaire.

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Development and validation of IMAQ: Integrative Medicine Attitude Questionnaire.

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