Perceived Efficacy in Patient‐Physician Interactions (PEPPI): Validation of an Instrument in Older Persons

Abstract

OBJECTIVE: To develop and validate a brief instrument – the Perceived Efficacy in Patient‐Physician Interactions Questionnaire (PEPPI) – to measure older patients' self‐efficacy in obtaining medical information and attention to their medical concerns from physicians. DESIGN: Two consecutive validation surveys. SETTING: Eleven senior multipurpose centers in Los Angeles County California. POPULATION: A convenience sample of 163 community‐dwelling older persons (Survey 1: n = 59, mean age = 77.1 years, 76.3% female; Survey 2: n = 104, mean age = 77.4 years, 57.7% female). MEASURES: The 10‐item PEPPI, subscales of the Patient Satisfaction Questionnaire, the Medical Outcomes Study (MOS) Coping Scale, the Mastery Scale, and global self‐reported health and restricted activity days items. RESULTS: The full 10‐item and a 5‐item short form of PEFPI demonstrated Cronbach's alphas of 0.91 and 0.83, respectively. PEPPI demonstrated discriminant and convergent validity as hypothesized, correlating negatively with avoidant coping ( r = ‐.27, P =.001) and positively with active coping (r =.17, P =.03) and with patient satisfaction with physician interpersonal manner (r =.49, P <.0001) and communication (r =.51, P <.0001) (values from the overall sample). Further, in the second survey, PEPPI correlated positively with self‐reported health (r =.42, P <.0001), education (r =.24, P =.01) and self‐mastery (r =.29, P =.01) and negatively with restricted activity days (r = ‐.25, P =.01). PEPPI‐5 demonstrated correlations similar in magnitude, direction, and statistical significance. CONCLUSION: In either the 5‐ or 10‐item version, PEPPI is a valid and reliable measure of older patients' perceived self‐efficacy in interacting with physicians. This instrument may be useful in measuring the impact of empowerment interventions to increase older patients' personal sense of effectiveness in obtaining needed health care.