PERCEIVED EFFICACY IN PATIENT-PHYSICIAN INTERACTIONS (PEPPI) - VALIDATION OF AN INSTRUMENT IN OLDER PERSONS

OBJECTIVE: To develop and validate a brief instrument the Perceived Ef ficacy in Patient-Physician Interactions Questionnaire (PEPPI) - to me asure older patients' self-efficacy in obtaining medical information a nd attention to their medical concerns from physicians. DESIGN: Two co nsecutive validation surveys. SETTING: Eleven senior multipurpose cent ers 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, 5 7.7% female). MEASURES: The 10-item PEPPI, subscales of the Patient Sa tisfaction Questionnaire, the Medical Outcomes Study (MOS) Coping Scal e, the Mastery Scale, and global self-reported health and restricted a ctivity days items. RESULTS: The full 10-item and a 5-item short form of PEPPI demonstrated Cronbach's alphas of 0.91 and 0.83, respectively . PEPPI demonstrated discriminant and convergent validity as hypothesi zed, 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 sel f-reported health (r = .42, P < .0001), education (r = .24, P = .01) a nd self-mastery (r = .29, P = .01) and negatively with restricted acti vity days (r = -.25, P = .01). PEPPI-5 demonstrated correlations simil ar in magnitude, direction, and statistical significance. CONCLUSION: In either the 5- or 10-item version, PEPPI is a valid and reliable mea sure of older patients' perceived self-efficacy in interacting with ph ysicians. This instrument may be useful in measuring the impact of emp owerment interventions to increase older patients' personal sense of e ffectiveness in obtaining needed health care.