Assessing the stages of the grieving process in chronic obstructive pulmonary disease (COPD): Validation of the Acceptance of Disease and Impairments Questionnaire (ADIQ)
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) encounter many (gradual) losses due to their disease, which trigger a grieving process. This process is characterized by stages of denial, resistance, sorrow, and acceptance.Purpose This study examined whether these stages are conceptually distinct and whether the Acceptance of Disease and Impairments Questionnaire (ADIQ) can validly and reliably measure these stages in three samples of patients with COPD in the Netherlands.Methods Exploratory factor analysis (EFA) was performed on 145 outpatients with moderate to severe COPD. Confirmatory factor analyses were performed on 303 outpatients with mild to very severe COPD and 127 patients entering an inpatient pulmonary rehabilitation program. Furthermore, internal reliability, construct validity, sensitivity to change, and floor and ceiling effects were examined.Results EFA yielded a four-factor solution that explained 73.2 % of variance. Confirmatory factor analyses showed a good fit of the four-factor structure in all study samples. Cronbach's alpha reliability coefficients were .79 or higher. Subscales showed to be sensitive to change.Conclusions Four distinct stages of grief are recognized in COPD. The ADIQ is a valid and reliable instrument to measure these stages: denial, resistance, sorrow, and acceptance. Measuring the stages of grieving is important for disease management: addressing patients with a specific therapeutic approach for the stage they are in could help to motivate patients to engage in self-management and change their lifestyle.
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The ADIQ is a valid and reliable instrument to measure 4 subscales of stages of grieving in disease management.
“the Acceptance of Disease and Impairments Questionnaire (ADIQ), a valid and reliable instrument to measure 4 subscales of stages of grieving in disease management: denial (4 items, range 4-16), resistance (3 items, range 3-12), sorrow (3 items, range 3-12), and acceptance (4 items, range 4-16) (Boer et al., 2014).”
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Cites
(1998) · Cited by 36,049 · see citing works
The satisfaction with life scale
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985) · Journal of Personality Assessment · doi:10.1207/s15327752jpa4901_13 · Cited by 31,768 · see citing works
Alternative Ways of Assessing Model Fit
Browne, M. W., & Cudeck, R. (1992) · Sociological Methods & Research · doi:10.1177/0049124192021002005 · Cited by 27,200 · see citing works
Comparative fit indexes in structural models.
Bentler, P. M. (1990) · Psychological Bulletin · doi:10.1037/0033-2909.107.2.238 · Cited by 25,266 · see citing works
Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0596pp · Cited by 15,983 · see citing works
Quality criteria were proposed for measurement properties of health status questionnaires
Terwee, C. B., Bot, S. D. M., de Boer, M. R., van der Windt, D. A. W. M., Knol, D. L., Dekker, J., Bouter, L. M., & de Vet, H. C. W. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.03.012 · Cited by 10,764 · see citing works
Applied Multivariate Statistics for the Social Sciences
Stevens, J. P. (2012) · Routledge eBooks · doi:10.4324/9780203843130 · Cited by 10,652 · see citing works
Goodall, C. R., & Jolliffe, I. T. (1988) · Technometrics · doi:10.2307/1270093 · Cited by 8,677 · see citing works
Jolliffe, I. T. (1986) · Springer series in statistics · doi:10.1007/978-1-4757-1904-8 · Cited by 8,367 · see citing works
Introduction to research in education
Ary, D. (1972) · Cited by 7,699 · see citing works
Global Initiative for Chronic Obstructive Lung Disease
Gerald, L. B., & Bailey, W. C. (2002) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-200207000-00004 · Cited by 5,824 · see citing works
Lung volumes and forced ventilatory flows
Quanjer, P. H., Tammeling, G. J., Cotes, J. E., Pedersen, O. F., Peslin, R., & Yernault, J. (1993) · European Respiratory Journal · doi:10.1183/09041950.005s1693 · Cited by 5,484 · see citing works
Applied multivariate statistics for the social sciences
Stevens, J. P., & Stevens, J. P. (2001) · doi:10.4324/9781410604491 · Cited by 4,993 · see citing works
Kübler-Ross, E. (1975) · PubMed · Cited by 4,937 · see citing works
The Sickness Impact Profile: Development and Final Revision of a Health Status Measure
Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981) · Medical Care · doi:10.1097/00005650-198108000-00001 · Cited by 4,619 · see citing works
Jones, P. W., Quirk, F. H., Baveystock, C. M., & Littlejohns, P. (1992) · American Review of Respiratory Disease · doi:10.1164/ajrccm/145.6.1321 · Cited by 3,035 · see citing works
The St George's Respiratory Questionnaire
Jones, P., Quirk, F. H., & Baveystock, C. M. (1991) · Respiratory Medicine · doi:10.1016/s0954-6111(06)80166-6 · Cited by 2,729 · see citing works
(2002) · Cited by 2,645 · see citing works
Individual-patient monitoring in clinical practice: are available health status surveys adequate?
McHorney, C. A., & Tarlov, A. R. (1995) · Quality of Life Research · doi:10.1007/bf01593882 · Cited by 2,206 · see citing works
Applied Multivariate Statistics for the Social Sciences
Schumm, W. R., & Stevens, J. P. (1993) · The American Statistician · doi:10.2307/2685203 · Cited by 1,532 · see citing works
Standardized lung function testing.
Thornton, J. C., & Miller, A. (1985) · PubMed · Cited by 1,323 · see citing works
Dimensional assessment of chronic fatigue syndrome
Vercoulen, J. H. M. M., Swanink, C. M. A., Fennis, J. F. M., Galama, J. M. D., van der Meer, J. W. M., & Bleijenberg, G. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90099-x · Cited by 1,306 · see citing works
Global Strategy for the Diagnosis, Management and Prevention of COPD: 2003 update
Fabbri, L. M., & Hurd, S. S. (2003) · European Respiratory Journal · doi:10.1183/09031936.03.00063703 · Cited by 1,277 · see citing works
Beck, A. T., Guth, D., Steer, R. A., & Ball, R. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00025-9 · Cited by 733 · see citing works
Beyond unfavorable thinking: the illness cognition questionnaire for chronic diseases
Evers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G., & Bijlsma, J. W. J. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.6.1026 · Cited by 657 · see citing works
Coping or acceptance? What to do about chronic pain
McCracken, L. M., & Eccleston, C. (2003) · Pain · doi:10.1016/s0304-3959(03)00202-1 · Cited by 591 · see citing works
Self-management education for patients with chronic obstructive pulmonary disease
Effing, T., Monninkhof, E. E., van der Valk, P. P. D. L. P. M., Zielhuis, G. G., Walters, E. H., van der Palen, J. J., & Zwerink, M. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002990.pub2 · Cited by 536 · see citing works
Measuring the global burden of disease and epidemiological transitions: 2002–2030
López, A. D., & Mathers, C. D. (2006) · Annals of Tropical Medicine and Parasitology · doi:10.1179/136485906x97417 · Cited by 462 · see citing works
Factors Associated With Medication Nonadherence in Patients With COPD
George, J., Kong, D. C. M., Thoman, R., & Stewart, K. (2005) · CHEST Journal · doi:10.1378/chest.128.5.3198 · Cited by 319 · see citing works
Viane, I., Crombez, G., Eccleston, C., Poppe, C., Devulder, J., Van Houdenhove, B., & De Corte, W. (2003) · Pain · doi:10.1016/s0304-3959(03)00291-4 · Cited by 282 · see citing works
Patient education for adults with rheumatoid arthritis
Riemsma, R. P., Kirwan, J., Taal, E., & Rasker, H. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003688 · Cited by 270 · see citing works
General psychological acceptance and chronic pain: There is more to accept than the pain itself
McCracken, L. M., & Zhao‐O'Brien, J. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2009.03.004 · Cited by 203 · see citing works
Self-management programmes for COPD
Effing, T., Bourbeau, J., Vercoulen, J. H. M. M., Apter, A. J., Coultas, D., Meek, P., van der Valk, P., Partridge, M. R., & van der Palen, J. A. M. (2012) · Chronic Respiratory Disease · doi:10.1177/1479972311433574 · Cited by 183 · see citing works
Adherence in the Treatment of Psoriasis: A Systematic Review
Augustin, M., Holland, B., Dartsch, D. C., Langenbruch, A. K., & Radtke, M. A. (2011) · Dermatology · doi:10.1159/000329026 · Cited by 156 · see citing works
[The sickness impact profile; results of an evaluation study of the Dutch version].
Jacobs, H. M., Luttik, A., Touw-Otten, F. W. M. M., & MELKER, R. A. D. (1990) · PubMed · Cited by 153 · see citing works
Blum, M. A., Koo, D., & Doshi, J. A. (2011) · Clinical Therapeutics · doi:10.1016/j.clinthera.2011.06.001 · Cited by 119 · see citing works
Evers, A. W. M., Duller, P., van de Kerkhof, P. C. M., van der Valk, P. G. M., de Jong, E. M. G. J., Gerritsen, M., Otero, E., Verhoeven, E. W. M., Verhaak, C. M., & Kraaimaat, F. (2007) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2007.08296.x · Cited by 113 · see citing works
Persons with insulin‐dependent diabetes mellitus: acceptance and coping ability
Richardson, A., Adner, N., & Nordström, G. M. (2001) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2001.01717.x · Cited by 112 · see citing works
Self-management of chronic low back pain and osteoarthritis
May, S. (2010) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2010.26 · Cited by 103 · see citing works
The Irrational Beliefs Inventory (IBI): Development and psychometric evaluation
Koopmans, P. C., Sanderman, R., Timmerman, I. G. H., & Emmelkamp, P. M. G. (1994) · UvA-DARE (University of Amsterdam) · Cited by 89 · see citing works
Assessment in Behavioral Medicine
(2013) · Routledge eBooks · doi:10.4324/9781315783185 · Cited by 74 · see citing works
Conceptualization and development of the acceptance of chronic health conditions scale
Stuifbergen, A., Becker, H., Blozis, S., & Beal, C. (2008) · Issues in Mental Health Nursing · doi:10.1080/01612840701792548 · Cited by 62 · see citing works
An integral assessment framework of health status in chronic obstructive pulmonary disease (COPD)
Vercoulen, J. H., Daudey, L., Molema, J., Vos, P. J. E., Peters, J. B., Top, M., & Folgering, H. T. M. (2008) · International Journal of Behavioral Medicine · doi:10.1080/10705500802365474 · Cited by 55 · see citing works
Karademas, E. C., Tsagaraki, A., & Lambrou, N. (2009) · Journal of Health Psychology · doi:10.1177/1359105309345169 · Cited by 52 · see citing works
Adherence to controller therapy for chronic obstructive pulmonary disease: a review
Charles, M. S., Blanchette, C. M., Silver, H., Lavallee, D. C., Dalal, A. A., & Mapel, D. W. (2010) · Current Medical Research and Opinion · doi:10.1185/03007995.2010.516284 · Cited by 46 · see citing works
A simple method to enable patient-tailored treatment and to motivate the patient to change behaviour
Vercoulen, J. H. (2012) · Chronic Respiratory Disease · doi:10.1177/1479972312459974 · Cited by 41 · see citing works
Karademas, E. C., & Hondronikola, I. (2010) · Psychology, Health & Medicine · doi:10.1080/13548501003668265 · Cited by 27 · see citing works
The poorly coping COPD patient: A psychotherapeutic perspective
Post, L., & Collins, C. (1982) · The International Journal of Psychiatry in Medicine · doi:10.2190/vuvv-2rqv-ag30-dpl1 · Cited by 20 · cited 4× · see citing works
“In the stage of acceptance, patients are able to restructure their life goals and expectations [4].”
BackgroundInfluentialTheory and Measurement: conceptualisation, operationalisation and the example of health status
Ogden, J. (2001) · Surrey Research Insight Open Access (The University of Surrey) · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Domain-specific cognitive impairment in patients with COPD and control subjects
Cleutjens, F. A. H. M., Franssen, F. M. E., Spruit, M. A., Vanfleteren, L. E. G. W., Gijsen, C., Dijkstra, J. B., Ponds, R., Wouters, E. F. �., & Janssen, D. J. A. (2016) · International Journal of COPD · doi:10.2147/copd.s119633 · Cited by 71 · see citing works
Factors influencing exacerbation-related self-management in patients with COPD: a qualitative study
Korpershoek, Y., Vervoort, S., nijssen, L., Trappenburg, J., & Schuurmans, M. (2016) · International Journal of COPD · doi:10.2147/copd.s116196 · Cited by 57 · see citing works
How do patients and carers make sense of renal dietary advice? A qualitative exploration
Lambert, K., Mansfield, K. J., & Mullan, J. (2018) · Journal of Renal Care · doi:10.1111/jorc.12260 · Cited by 56 · see citing works
Goërtz, Y. M. J., Looijmans, M., Prins, J. B., Janssen, D. J. A., Thong, M. S. Y., Peters, J. B., Burtin, C., Meertens-Kerris, Y., Coors, A., Muris, J. W. M., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-021745 · Cited by 38 · see citing works
Thijssen, C. G. E., Doze, D. E., Gökalp, A. L., Timmermans, J., Peters, J. B., de Ven, L. E.-V., van Royen, N., Takkenberg, J. J. M., Roos‐Hesselink, J. W., & van Kimmenade, R. R. J. (2020) · Journal of Genetic Counseling · doi:10.1002/jgc4.1288 · Cited by 27 · see citing works
Resilience Factors Important in Health-Related Quality of Life of Subjects With COPD
Cannon, D., Sriram, K. B., Liew, A. W., & Sun, J. (2018) · Respiratory Care · doi:10.4187/respcare.05935 · Cited by 24 · see citing works
Wang, W., Yang, C., Wang, B., Chen, X., Wang, B., & Yuan, W. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01317 · Cited by 21 · see citing works
Illness denial questionnaire for patients and caregivers
Ferrario, S. R., Giorgi, I., Baiardi, P., Giuntoli, L., Balestroni, G., Cerutti, P., Manera, M. R., Gabanelli, P., Solara, V., Fornara, R., et al. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s128622 · Cited by 18 · see citing works
Peters, J. B., Antons, J. C., Koolen, N., van Helvoort, H. A. C., van Hees, H. W. H., van den Borst, B., Spruit, M. A., Vercoulen, J. H. M. M., & Hul, A. J. V. ‘. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.947402 · Cited by 16 · see citing works
Consensus Recommendations for the Use of Simulation in Therapeutic Patient Education
Penneçot, C., Gagnayre, R., Ammirati, C., Bertin, É., Capelle, D., Cheraitia, E., Chiniara, G., David, V., Tribonnière, X. D. L., Decelle, B., et al. (2020) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000401 · Cited by 14 · see citing works
Disease self-management in patients with moderate COPD: a thematic analysis
Molin, K. R., Langberg, H., Lange, P., & Egerod, I. (2020) · European Clinical Respiratory Journal · doi:10.1080/20018525.2020.1762376 · Cited by 11 · see citing works
Status disclosure and the acceptance of women living with HIV
Ristriyani, R., Rachmawati, I. N., & Afiyanti, Y. (2018) · Enfermería Clínica · doi:10.1016/s1130-8621(18)30066-4 · Cited by 10 · see citing works
van Loenhout, J. A. F., Hautvast, J. L. A., Akkermans, R. P., Donders, N. C. G. M., Vercoulen, J. H., Paget, W. J., & van der Velden, K. (2015) · Scandinavian Journal of Public Health · doi:10.1177/1403494815571030 · Cited by 9 · see citing works
Zeng, S. Y., Wu, R. C., Truong, K. N., & Chevalier, F. (2020) · Proceedings of the ACM on Interactive Mobile Wearable and Ubiquitous Technologies · doi:10.1145/3432218 · Cited by 8 · see citing works
Conceptualizing an HIV Diagnosis Through a Model of Grief and Bereavement
Zeligman, M. R., & Wood, A. W. (2017) · Adultspan Journal · doi:10.1002/adsp.12031 · Cited by 8 · see citing works
Siemann, I., Custers, J., van den Heuvel-Djulic, S., Pouwels, S., Kwakkenbos, L., & Spillekom-van Koulil, S. (2023) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2022.03.005 · Cited by 7 · see citing works
Effects of Adherence to an mHealth Tool for Self-Management of COPD Exacerbations
Bischoff, E. W. M. A., Ariens, N., Boer, L. M., Vercoulen, J. H., Akkermans, R. L. C., van den Bemt, L., & Schermer, T. R. (2023) · International Journal of COPD · doi:10.2147/copd.s431199 · Cited by 7 · see citing works
Bremond, M., Berthelot, A., Plantier, L., Breton, H., & Pautrat, M. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049121 · Cited by 7 · see citing works
Tülüce, D., Köktürk, N., Geniş, B., Kayalar, A., Gürhan, N., & Kutlutürkan, S. (2021) · Turkish Thoracic Journal · doi:10.5152/turkthoracj.2021.0004 · Cited by 6 · see citing works
VIDDE: Visualizations for Helping People with COPD Interpret Dyspnea During Exercise
Chen, C., Wu, R. C., Khan, H., Truong, K. N., & Chevalier, F. (2021) · International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS) · doi:10.1145/3441852.3471204 · Cited by 7 · see citing works
Physical Inactivity, Self-Management, and Living Well With COPD
Coultas, D. (2017) · American Journal of Lifestyle Medicine · doi:10.1177/1559827617700596 · Cited by 5 · see citing works
De NCSI-methode: maatwerk voor COPD-zorg
Bischoff, E. W. M. A., Vercoulen, J. H. M. M., Elbers, L., Behr, R., & Schermer, T. R. (2016) · Huisarts en Wetenschap · doi:10.1007/s12445-016-0151-8 · Cited by 3 · see citing works
BERDUKA PADA PEREMPUAN HIV POSITIF
Ristriyani, R., Rachmawati, I. N., & Afiyanti, Y. (2018) · Jurnal Keperawatan Indonesia · doi:10.7454/jki.v21i1.543 · Cited by 2 · see citing works
Gaveel, T. J., Postma, E. M., Bloem, B. R., Darweesh, S. K. L., Munneke, M., Overbeek, K., Helmich, R. C. G., Zeevat, F., Zijlstra, M., Boersma, C., et al. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1752073 · Cited by 1 · see citing works
Psychological Considerations in Pulmonary Rehabilitation
Harrison, S. L., & Robertson, N. (2017) · Springer eBooks · doi:10.1007/978-3-319-65888-9_13 · Cited by 1 · see citing works
A Review of Non-Pharmacological Pulmonary Rehabilitation for Patients Receiving Palliative Care
Dawson, K., Freeman, S., & Adam, K. (2017) · Pulmonary Research and Respiratory Medicine - Open Journal · doi:10.17140/prrmoj-se-2-105
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Nistiandani, A., Juniarto, A. Z., & Dyan, N. S. (2019) · JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery) · doi:10.21927/jnki.2018.6(1).25-31
Self-management support using mHealth in patients with COPD
Korpershoek, Y. (2021) · doi:10.33540/518
Persona, J. (2019) · Persona Jurnal Psikologi Indonesia · doi:10.30996/persona.v8i1.2551
Bremond, M. (2024) · doi:10.70675/ca5cb2c4z19c5z40dbz9ea3z31362e436204
Designing Ethical AI Grief Support: A Value Sensitive Design Framework for Chronic Illness Care
Jia, S., Chi, O. H., & Tseng, H.-T. (2026) · ACM SIGMIS Database the DATABASE for Advances in Information Systems · doi:10.1145/3822165.3822169
- Authors
- Boer, L. M., Daudey, L., Peters, J. B., Molema, J., Prins, J. B., & Vercoulen, J. H.
- Affiliations
- Radboud University Medical Center (NL)
- Corresponding author
- Boer, Lonneke M.
- Venue
- International Journal of Behavioral Medicine
- Published
- 2013-05-04
- Volume
- 21
- Issue
- 3
- Pages
- 561-570
- ISSN
- 1070-5503 (ISSN-L)
- 1532-7558
- OpenAlex
- W2088041874
- Cited by
- 32
- References
- 49
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- chronic obstructive pulmonary disease, grief, stages of grief, questionnaire validation, psychometric properties, denial, resistance, sadness, acceptance, pulmonary rehabilitation, self-management
- MeSH terms
- Adaptation, Psychological, Aged, Factor Analysis, Statistical, Female, Grief, Humans, Male, Middle Aged, Netherlands, Surveys and Questionnaires, Severity of Illness Index, Reproducibility of Results, Pulmonary Disease, Chronic Obstructive
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