Dyadic Asthma Management Questionnaire (DAMQ)

Abstract

The Dyadic Asthma Management Questionnaire (DAMQ), developed by Heyduck-Weides et al. (2023), is a specialized psychometric evaluation tool designed to quantify the perception of shared responsibility and collaboration in the context of Asthma Management between adolescents and their primary caregivers. The scale is unique in its dyadic design, featuring parallel versions for both the adolescent patient and the caregiver to capture divergent perspectives.

The development process for the DAMQ rigorously followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist (Mokkink et al., 2018). Initial item generation involved a combination of theoretical grounding, literature review, and semi-structured interviews with the target population, resulting in 46 preliminary items. These items were theoretically categorized into two core dimensions of the adolescent-caregiver partnership: Responsibility Sharing and Collaboration. Subsequent empirical testing, including both exploratory and factor analyses, supported a final, robust 26-item structure, with each version representing three distinct latent constructs. The DAMQ’s reliability, validity, and measurement invariance have been established through data collected from dyads in Germany.

Keywords

Adolescent Version, Adolescent-Caregiver Asthma Management, Caregiver Version, Collaboration, Juvenile Asthma Management, Responsibility Sharing, Structural Validity, Dyadic Assessment, Chronic Disease Management.

Authors

Heyduck-Weides, Katja, Bengel, Jürgen, Farin, Erik, Glattacker, Manuela.

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Purpose

The primary purpose of the DAMQ is to provide a standardized, dyadic measure capable of assessing the viewpoints of both adolescents and their caregivers regarding the management of the adolescent’s asthma. By utilizing parallel versions, the instrument allows researchers and clinicians to identify discrepancies or agreements in perceived roles and collaborative efforts, which are crucial for effective chronic disease management.

Specifically, the scale was developed to quantify the dynamics of shared management tasks, helping to pinpoint areas where responsibility transfer may be incomplete or where collaborative support is lacking. This information is vital for tailoring interventions aimed at improving self-management skills in adolescents with asthma.

Construct

The DAMQ measures the complex dyadic partnership in asthma care, focusing on two overarching theoretical dimensions, each supported by three distinct subscales:

• Responsibility Sharing: This dimension assesses the allocation of specific asthma management tasks between the adolescent and the caregiver. The items cluster into three factors: Asthma attack management and prevention, Medical and school-related procedures, and Self-care behaviors.

• Collaboration: This dimension evaluates the quality and nature of the supportive interactions provided by the caregiver, addressing six key aspects that ultimately load onto three factors: Teaching and emotional support, Monitoring and instrumental support, and Promoting autonomy.

Validity

The validation of the DAMQ included rigorous assessment of both content and construct validity.

Content Validity: Content validity was established through expert review. A panel of consultants from the participating rehabilitation centers evaluated the DAMQ items, leading to necessary rephrasing of some items and revisions to the overall layout and instructions to ensure clarity and relevance to the target population.

Construct Validity: Construct Validity was evaluated through hypotheses testing, examining correlations between the DAMQ scales and established measures of related psychological constructs. Significant correlations were observed with the Short Self-Management Questionnaire for Adolescents with Asthma (KM-J-AB; Petermann et al., 2009), the juvenile quality of life measure (DISABKIDS Chronic Generic Measure, DCGM-12; DISABKIDS Group Europe, 2006), and the parental quality of life measure (Ulm Quality of Life Inventory for Parents of chronically ill children, ULQIE; Goldbeck & Storck, 2002). Notably, positive correlations with the KM-J-AB (which assesses actual asthma behavior over the preceding seven days) were specifically confirmed for the collaboration scales, supporting the theoretical distinction between shared responsibility and active collaborative support.

Reliability

Internal Consistency: The reliability of the DAMQ was demonstrated through strong measures of Internal Consistency. For both the adolescent and caregiver versions of the scale, the internal consistency values—measured using Cronbach’s alpha (α), omega (ω), and the greatest lower bound (glb)—were consistently reported as being greater than 0.70 across all scales, indicating high reliability for research and clinical application.

Factor Analysis

The scale’s structure was confirmed using a combination of exploratory and confirmatory statistical methods.

Exploratory Factor Analysis (EFA): For the responsibility sharing dimension, EFA, guided by eigenvalues and scree plots, suggested a consistent three-factor model for both adolescent and caregiver datasets. Similarly, for the collaboration dimension across both versions, scree plots indicated that three factors should be retained, capturing three distinct aspects of parental collaborative involvement.

Confirmatory Factor Analysis (CFA): The structural validity of the derived model was confirmed using CFA. The model-fit indices demonstrated acceptable to good fit for the data: the Chi-square statistic was acceptable (χ² = 361.3 [df = 270], p = 0.226), and key indices met established thresholds (TLI = 0.91; CFI = 0.92; RMSEA = 0.06; SRMR = 0.07).

Measurement Invariance: Analyses tested measurement invariance across different age groups of adolescents. The findings revealed a good to excellent fit for adolescents aged 14 years and older, though the fit was slightly poorer for adolescents younger than 14 years, suggesting potential developmental differences in the conceptualization of responsibility and collaboration.

Instrument

Test Type: Original

Format: The instrument is administered via a paper-based method. The items are scored using distinct response scales based on the dimension being measured. Responsibility sharing items use a 5-point scale ranging from 1 = caregiver takes responsibility for this all of the time to 5 = adolescent takes responsibility for this all of the time, with a midpoint of 3 = caregiver and adolescent share equal responsibility. An optional response of 0 = not needed is included for tasks irrelevant to the individual patient’s Asthma Management. Collaboration items are scored on a 5-point frequency scale: 1 = never, 2 = rarely, 3 = sometimes, 4 = usually, and 5 = always.

Language Available: German. The source material refers to studies conducted using both English and German language materials.

Population Group: Human (Male and Female).

Age Group: Applicable to Childhood (birth-12 yrs), School Age (6-12 yrs), Adolescence (13-17 yrs), Adulthood (18 yrs & older), and Young Adulthood (18-29 yrs), though specific validation focused on the adolescent range.

Population Details: The study participants used for scale development and validation were adolescent asthma patients and their primary caregivers located in Germany.

Test Methodology: Test Validity, Construct Validity, Content Validity, Test Reliability, Internal Consistency, Factor Analysis, Confirmatory Factor Analysis, Exploratory Factor Analysis, Measurement Invariance.

Keywords

Asthma, Collaboration, Disease Management, Responsibility Sharing, Self-Report, Parent Report, Physical Health Assessment, Psychometrics, Dyadic Communication.

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Authors

Heyduck-Weides, Katja

• Author ORCID Identifier: http://orcid.org/0000-0001-8487-4642

• Affiliation: University of Freiburg, Faculty of Medicine Medical Center – University of Freiburg, Section of Health Care Research and Rehabilitation Research

Bengel, Jürgen

• Affiliation: University of Freiburg Department of Rehabilitation Psychology and Psychotherapy

Farin, Erik

• Author ORCID Identifier: http://orcid.org/0000-0001-6867-0316

• Affiliation: University of Freiburg, Faculty of Medicine Medical Center – University of Freiburg, Section of Health Care Research and Rehabilitation Research

Glattacker, Manuela

• Author ORCID Identifier: http://orcid.org/0000-0003-4300-2201

• Affiliation: University of Freiburg, Faculty of Medicine Medical Center – University of Freiburg, Section of Health Care Research and Rehabilitation Research

Correspondence Address: Heyduck-Weides, Katja: University of Freiburg, Faculty of Medicine, Medical Center – University of Freiburg, Section of Health Care Research and Rehabilitation Research, Hugstetter Str. 49, Freiburg, Germany, 79106, [email protected]

Permissions & Fee and Test Year

• Permissions: Contact Corresponding Author

• Fee: No

• Commercial: No

• Test Year: 2023

Reference’s

Heyduck-Weides, K., Bengel, J., Farin, E., & Glattacker, M. (2023). The dyadic asthma management questionnaire for adolescents and their caregivers: Development and psychometric evaluation. European Journal of Health Psychology, 30(4), 145–156. https://doi.org/10.1027/2512-8442/a000131

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Items of the Dyadic Asthma Management Questionnaire (DAMQ)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

No data is Available