Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP)

Julie F Pallant,Elizabeth Bennett,RoseAnne Misajon,Lenore Manderson

doi:10.1186/1477-7525-4-36

Abstract

BackgroundThe aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP). Based on the biopsychosocial model of health and functioning, the PIPP was intended as a generic research and clinical measurement tool to assess the impact and distress of health conditions from the individuals' perspective. The ICF classification system was used to guide the structure of the PIPP with subscales included to assess impact on self-care, mobility, participation, relationships and psychological well-being. While the ICF focuses on the classification of objective health and health related status, the PIPP broadens this focus to address the individuals' subjective experience of their health condition.MethodsAn item pool of 23 items assessing both impact and distress on five key domains was generated. These were administered to 169 adults with mobility impairment. Rasch analysis using RUMM2020 was conducted to assess the psychometric properties of each set of items. Preliminary construct validation of the PIPP was performed using the EQ5D.ResultsFor both the Impact and Distress scales of the PIPP, the five subscales (Self-care, Mobility, Participation, Relationships, and Psychological Well-being) showed adequate psychometric properties, demonstrating fit to the Rasch model. All subscales showed adequate person separation reliability and no evidence of differential item functioning for sex, age, educational level or rural vs urban residence. Preliminary validity testing using the EQ5D items provided support for the subscales.ConclusionThis preliminary study, using a sample of adults with mobility impairment, provides support for the psychometric properties of the PIPP as a potential clinical and research measurement tool. The PIPP provides a brief, but comprehensive means to assess the key ICF components, focusing on the individuals' perspective of the impact and distress caused by their health condition. Further validation of its use across different health conditions and varying cultural settings is required.

Highlights

The aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP)
Within the traditional medical model, disability is viewed as a characteristic of an individual that is caused by the health condition, requiring the need for medical intervention by professionals to manage the condition
The results of this study suggest that individuals with similar impairment levels can have very different levels of personal impact arising from the impairment

Summary

Introduction

The aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP). Within the framework of the ICF, disability and functioning are seen as the result of complex interactions between health conditions and contextual factors, both environmental and personal. Environmental factors, both physical (climate, terrain, architecture) and social (legal and social structures, cultural and social attitudes), and personal factors, such as gender, age, education, character, coping styles and past experience, may all contribute to the impact of a specific health condition on an individual. Coupled with the shift in emphasis on the social construction of disability, there has been a growing awareness of the need to measure the impact of a health condition from the individual's perspective, taking into account social context and personal factors

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