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Assessment of readiness to change in patients with osteoarthritis. Development and application of a new questionnaire

Rehabilitation Foundation Limburg, Hoensbroek and Department of General Practice, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands

Rob A de Bie

Department of Epidemiology, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands

Arie Dijkstra

Department of Social and Organizational Psychology, University of Groningen, Maastricht, The Netherlands

Karin Aretz

Department of General Practice, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands

Johan WS Vlaeyen

Department of Medical, Clinical and Experimental Psychology, Maastricht University, Maastricht, The Netherlands

Hubert JA Schouten

Department of Methology and Statistics, Maastricht University, Maastricht, The Netherlands

Marijke Hopman-Rock

Department of Physical Activity and Health, TNO Prevention and Health, Leiden, Maastricht, The Netherlands

Chris van Weel

Department of Family Medicine, University Medical Centre St Radboud, Nijmegen, Maastricht, The Netherlands

Constant P van Schayck

Department of General Practice, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands

Objective: To develop a self-report measure for assessment of the stage of change in patients with osteoarthritis, in order to identify patients who would benefit from a self-management programme.

Methods: According to the ‘stages of change’ model a questionnaire was developed with three groups of items corresponding to the precontemplation stage (Pre), the contemplation (Cont) and the action (Act) stage. Internal consistency and factor structure of this questionnaire were investigated by assessing Cronbach's alphas and by performing factor analysis.

Subjects and setting: The questionnaire was offered to 273 patients who entered a randomized clinical trial on self-management in a general health care setting.

Results: Factor analysis revealed that most items corresponded to the a priori described groups, while some items were not loading on the presumed factor. In each subgroup some items were deleted, resulting in a 15-item questionnaire. After this item reduction Cronbach's alphas were 0.72 (Pre), 0.76 (Cont) and 0.79 (Act) and all factor loadings were satisfactory (above 0.35). Classification revealed some differences between parts of the total group, for example in the proportion of patients in the preparation stage (recruited by general practitioner 33.6%; advertisement 49.2%).

Conclusions: The Stages of Change Questionnaire in Osteoarthritis, a 15-item questionnaire to assess the ‘stage of change’ of a patient with osteoarthritis showed good internal consistency and adequate factor structure. These findings warrant further studies on validity and applicability in a clinical context.

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