Health and Disability Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction – the Swedish version EVA BRINK, 1,2 PIA ALSE ´ N 2 and CHRISTINA CLIFFORDSON 2 1 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 2 Department of Nursing, Health and Culture, University West, Trollha ¨ttan, Sweden Brink, E., Alse ´n, P. & Cliffordson, C. (2011). Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction – the Swedish version. Scandinavian Journal of Psychology 52, 573–579. When people’s health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cycli- cal, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also inves- tigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach’s alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R’s seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception. Key words: Illness perception, myocardial infarction, psychometric validation. Eva Brink, RN, PhD, Associate Professor, Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE 405 30 Gothenburg, Sweden. Tel: +46 31 7866104; e-mail: eva.brink@gu.se INTRODUCTION Although there has been a decline in the incidence of coronary heart disease in the Western world, many persons still suffer from health problems during periods of rehabilitation following a myo- cardial infarction (Schweikert, Hunger, Meisinger, Ko ¨nig, Gapp & Holle, 2009). Rehabilitation is influenced not only by clinical status, but also by a person’s beliefs systems, and for this reason the illness perception approach may be useful in research on ill- ness adjustment and outcomes (Petrie & Weinman, 2006). Upon becoming aware that one’s health is threatened, people generally develop beliefs as a means of making sense of their illness. These beliefs are called illness perceptions or illness representations and are related to coping strategies and health outcomes (Hagger & Orbell, 2003). In international research on coronary heart disease, a number of associations have been explored between illness perceptions and outcomes such as, for example, experiences of complications (Cherrington, Moser, Lennie & Kennedy, 2004), depression (Dickens, McGowan, Percival et al., 2008; Grace, Krepostman, Brooks et al., 2005; Juergens, Seekatz, Moosdorf, Petrie & Rief, 2010), quality of life (Lau-Walker, Cowie & Roughton, 2009; Stafford, Berk & Jackson, 2009), return to work (Petrie, Cameron, Ellis, Buick & Weinman, 2002), and attendance of rehabilitation programs (French, Cooper & Weinman, 2006). At present, illness beliefs are commonly assessed using the Revised Illness Percep- tion Questionnaire (IPQ-R), a validated measure across different illness groups, developed by Moss-Morris, Weinman, Petrie, Cameron, and Buick (2002). The IPQ-R has been widely used and translated into a number of languages. However, studies in this vital research area have been lacking in Sweden, meaning therefore that a psychometric evaluation of a Swedish version of IPQ-R seems warranted. The illness perception measures are based on the theory of self- regulation and have been developed in the form of the Common Sense Model of Self-Regulation (CSM) by Leventhal and col- leagues (Leventhal & Diefenbach, 1991; Leventhal, Nerentz & Steele, 1984). According to this theoretical model, both cognitive and emotional representations are encountered in relation to health threats. CSM is a dynamic model, meaning that these two sets of representations are appraised on an ongoing basis and may be modified during different stages of a disease. The basic premise of the theory is that individuals are active problem-solvers who make sense of a threat to their health. An internal or external stimulus (e.g., symptom or diagnosis) leads to common-sense perceptions of illness that guide coping behavior. Individuals behave in ways consistent with their own views. The Revised Illness Perception Questionnaire (IPQ-R) is a revised form of the Illness Perception Questionnaire (IPQ) which was developed to measure cognitive illness representations – iden- tity, consequences, timeline, control/cure and cause – and is suited to understanding and improving people’s management of illness and health-threatening conditions (Weinman, Petrie, Moss-Morris & Horne, 1996). Further, in the development of the IPQ-R, the Ó 2011 The Authors. Scandinavian Journal of Psychology Ó 2011 The Scandinavian Psychological Associations. Published by Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA. ISSN 0036-5564. Scandinavian Journal of Psychology, 2011, 52, 573–579 DOI: 10.1111/j.1467-9450.2011.00901.x