The utility of the Illness Perception Questionnaire in the evaluation of mental health practitioners’ perspectives on patients with schizophrenia Mick P. Fleming RN BA MA YCAP, 1 Colin R. Martin RN BSc PhD YCAP CPsychol CSci AFBPsS, 2 Jeremy Miles BSc PhD 3 and John Atkinson RN BA PhD 4 1 Lecturer in Mental Health, 2 Professor of Mental Health, 4 Associate Dean, School of Health, Nursing and Midwifery, University of the West of Scotland, Ayr, UK 3 Quantitative Psychologist, The RAND Corporation, Santa Monica, CA, USA Keywords confirmatory factor analysis, evaluation, illness perception, practitioners perspectives, schizophrenia Correspondence Professor Colin R. Martin School of Health, Nursing and Midwifery University of the West of Scotland Ayr KA8 OSR UK E-mail: colin.martin@uws.ac.uk Accepted for publication: 5 August 2008 doi:10.1111/j.1365-2753.2008.01103.x Abstract Rationale, aims, objectives The Illness Perception Questionnaire (IPQ) was designed as a measure of illness perception and has been used extensively for measuring the percep- tions of people with physical illness. Latterly modified versions of the IPQ have been used to measure the illness perceptions of people with mental health problems and their carers. This study examined the utility of a modified version of the IPQ to measure changes in mental health practitioners’ illness perceptions about schizophrenia after undertaking psy- chosocial intervention training. Method A total of 245 mental health practitioners who undertook psychosocial interven- tion training completed a modified version of the IPQ before and after training. The structure of the questionnaire was tested using confirmatory factor analysis. The internal consistency of sub-scales embedded in the instrument was also examined. Results The hypothesized structure failed to account for the data. Model fit indices revealed a poor fit to the data across all models evaluated. Cronbach’s alpha revealed a number of sub-scales in the instrument to have mediocre internal consistency characteristics. Conclusions The modified version of the IPQ is not suitable for evaluating the impact of psychosocial intervention training on changes in illness perceptions of schizophrenia in mental health practitioners. However, the study has highlighted the need to develop a valid and reliable measure to assess the illness perceptions health professionals have of patients in their care. Introduction The Illness Perception Questionnaire (IPQ) [1] was developed as a comprehensive assessment measure to accurately assess an indi- vidual’s appraisal of their disease. Conceptualized within Lev- enthal’s self-regulatory model [2] the IPQ comprised five scales: (i) illness identity; (ii) cause; (iii) timeline; (iv) consequences; and (v) control/cure. Thirty-six items were included in the original IPQ [1]. Data were collected from patients grouped by a broad range of clinical presentations, though a salient aspect to the instrument development in this respect was a focus on patients experiencing chronic illness. In the initial study data were collected from seven illness groups: hospitalized myocardial infarction, discharged after myocardial infarction, chronic fatigue syndrome, rheumatoid arth- ritis, diabetes, pain, renal and asthma. The data were analysed sepa- rately for each of the illness groups and the authors concluded that the internal consistency and test–retest reliability of the separate scales was encouraging. The timeline and cure/control scales both had lower internal consistency. The authors suggested that further studies were required to test the IPQ’s psychometric properties [1]. The IPQ has been adapted and utilized in a diverse range of illnesses, for example, coronary heart disease [3,4], HIV/AIDS [5,6], breast cancer [7,8] and diabetes [9,10]. The scale has been modified in recent years ostensibly to improve the measurement characteristics of the instrument [11]. Additionally, a further sub- scale was incorporated relating to the emotional representations of illness as was indicated in Leventhal’s self-regulatory model [2]. This modified version of the IPQ, the IPQ-R [11] was found to have good internal reliability, discriminant validity and offer a comprehensive and acceptable assessment of the main dimensions associated with the patients’ perceptions of illness [11]. The IPQ carers and mental illness perceptions A further modified version of the IPQ was developed by Barrow- clough et al. [12] to assess the carer’s illness perceptions of people Journal of Evaluation in Clinical Practice ISSN 1356-1294 © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 15 (2009) 826–831 826