Development and psychometric properties of the Maastricht Personal Autonomy Questionnaire (MPAQ) in older adults with a chronic physical illness Godelief M. J. Mars • Jacques Th. M. van Eijk • Marcel W. M. Post • Ireen M. Proot • Ilse Mesters • Gertrudis I. J. M. Kempen Accepted: 30 December 2013 / Published online: 11 January 2014 Ó Springer Science+Business Media Dordrecht 2014 Abstract Purpose To develop and test the Maastricht Personal Autonomy Questionnaire (MPAQ), an instrument measur- ing personal autonomy of older adults with a chronic physical illness in accordance with their experience of autonomy. Achievement of personal autonomy is concep- tualized as correspondence between the way people’s lives are actually arranged and the way people want to arrange their lives. Methods A field test was conducted in three waves (n = 412, n = 125 and n = 244) among a random sample of people older than 59 years with either chronic obstruc- tive pulmonary disease or diabetes mellitus. Construct validity, reproducibility and responsiveness were evaluated. Results The MPAQ entailing 16 items consists of three scales: degree of (personal) autonomy, working on auton- omy and dilemmas. Construct validity was largely sup- ported by confirmatory factor analysis and correlations between the MPAQ and other instruments. Intraclass cor- relation coefficients ranged from 0.61 to 0.80 and SRDs group from 0.10 to 0.13. Mean change was larger (0.54) than was SRD group (0.11) in patients who had deteriorated, but smaller in patients who had improved (0.07). Conclusions The MPAQ has good content and construct validity and moderate reproducibility. Responsiveness is weak, although better for deterioration than for improvement. Keywords Chronic disease  Personal autonomy  Psychometrics  COPD  Diabetes mellitus  Aged Introduction Patient-centered methods in health care have been devel- oped to increase autonomy of patients with a chronic ill- ness. These methods stress the need to see people as individuals rather than patients [1]. One should not only be concerned with autonomy people experience in interaction with caregivers, but also with autonomy in individuals’ lives in general, i.e., personal autonomy. Evaluations of patient-oriented methods should therefore include an assessment of personal autonomy. To this end, we devel- oped the Maastricht Personal Autonomy Questionnaire (MPAQ). Existing instruments for autonomy beyond the consul- tation room far mostly measure autonomy in relation to participation [2], assess autonomy as a trait rather then a state [3] or refer to contexts other than chronic illness, like adolescence or gender identity [4, 5]. In contrast, the MPAQ intends to measure personal autonomy of older adults with a chronic physical illness in a way that agrees with their own experience of autonomy. Based on a pre- vious work [6] and an extensive qualitative study [7], the MPAQ measures (1) achievement of autonomy,( 2) the dilemmas people with a chronic illness may face and (3) G. M. J. Mars  J. Th. M. van Eijk  I. Mesters  G. I. J. M. Kempen (&) CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands e-mail: g.kempen@maastrichtuniversity.nl M. W. M. Post Rudolf Magnus Institute of Neuroscience and Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands I. M. Proot Governor Kremers Centre—Maastricht University and Department Patient and Care, University Hospital Maastricht, Maastricht, The Netherlands 123 Qual Life Res (2014) 23:1777–1787 DOI 10.1007/s11136-013-0619-y