Abstract
BackgroundThe Perceived Impact of Problem Profile (PIPP) was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the ICF model as a framework. One of the aims of the ICF is to enable the comparison of data across countries, however, relatively little is known about the subjective experience of disability in middle and low-income countries. The aim of this study was to assess the validity of the Perceived Impact of Problem Profile (PIPP) for use among adults with a disability in Thailand using Rasch analysis.MethodsA total of 210 adults with mobility impairment from the urban, rural and remote areas of northeast Thailand completed the PIPP, which contains 23 items assessing both impact and distress across five key domains (Self-care, Mobility, Participation, Relationships, and Psychological Well-being). Rasch analysis, using RUMM2020, was conducted to assess the internal validity and psychometric properties of the PIPP Impact subscales. Validation of the PIPP Impact scales was conducted by comparing scores across the different response levels of the EQ5D items.ResultsRasch analysis indicated that participants did not clearly differentiate between 'impact' and 'distress,' the two aspects assessed by the PIPP. Further analyses were therefore limited to the PIPP Impact subscales. These showed adequate psychometric properties, demonstrating fit to the Rasch model and good person separation reliability. Preliminary validity testing using the EQ5D items provided support for the PIPP Impact subscales.ConclusionThe results provide further support for the psychometric properties of the PIPP Impact scales and indicate that it is a suitable tool for use among adults with a locomotor disability in Thailand. Further research is needed to validate the PIPP across different cultural contexts and health conditions and to assess the usefulness of separate Impact and Distress subscales.
Highlights
The Perceived Impact of Problem Profile (PIPP) was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the The International Classification of Functioning (ICF) model as a framework
As part of the RESILIENCE project, we developed the Perceived Impact of Problem Profile (PIPP [9]) as a relatively short, self-report instrument to assess, from the individual's point of view, the impact and distress associated with a health condition, rather than the person's ability to perform a particular task [9]
Removal of the item carry resulted in no differential item functioning (DIF) for any item, improved model fit and good person separation (PSI = .85)
Summary
The Perceived Impact of Problem Profile (PIPP) was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the ICF model as a framework. The International Classification of Functioning, Disability and Health (ICF) was developed by the World Health Organization (WHO) [1] to provide a standard, unified language and framework to describe health and healthrelated states. A specific aim of the ICF is to enable the comparison of data across countries and health care disciplines. An advancement of the ICF, compared with previous classification tools, was to incorporate contextual factors, including physical and social environmental factors as well as personal factors (e.g. age, education, coping styles), into a model of functioning and disability. Limited attention has been given to non-clinical, social and personal aspects of health, disability and illness [2]
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