Development and Validation of the Beliefs and Behaviour Questionnaire (BBQ)

Patient Educ Couns. 2006 Dec;64(1-3):50-60. doi: 10.1016/j.pec.2005.11.010. Epub 2006 Jul 14.


Objective: To develop and validate a questionnaire to screen for potential nonadherence in patients with chronic ailments.

Methods: Themes from qualitative interviews with chronic obstructive pulmonary disease patients were used in developing content of the questionnaire. The questionnaire was distributed to 525 ambulatory patients with chronic lung diseases. Principal components analysis was performed to identify the subscales in the questionnaire. Internal consistency, validity and stability of the subscales were also evaluated.

Results: The 30-item Beliefs and Behaviour Questionnaire (BBQ) measures beliefs, experiences and adherent behaviour on five-point Likert-type scales. Two hundred and eighty patients (53.3%) with a mean age of 71.1 years responded to the questionnaire. The 'beliefs' section had a two-factor solution-'confidence' and 'concerns' with internal consistencies of 0.82 and 0.45, respectively. The two domains identified from the section 'experiences'-satisfaction' and 'disappointment' had internal consistencies of 0.85 and 0.52, respectively. The 'behaviour' section, separately entitled the Tool for Adherence Behaviour Screening (TABS), had a two-factor solution--'adherence' and 'nonadherence', with internal consistencies of 0.80 and 0.59, respectively. All the domains demonstrated comparable reliabilities across two different patient populations. Their temporal stabilities ranged between 0.62 and 0.94.

Conclusion: The validity, reliability and utility of the BBQ and the TABS, a sub-scale of the BBQ that screens both intentional and unintentional nonadherence to pharmacological and non-pharmacological disease management, have been established.

Practice implications: The BBQ and the TABS have potential applications in screening adherence beliefs, experiences and behaviour in both clinical practice and research.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Drug Therapy / psychology
  • Factor Analysis, Statistical
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Mass Screening / methods
  • Models, Psychological
  • Motivation
  • Nursing Assessment / methods
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Patient Compliance / psychology*
  • Patient Education as Topic
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / prevention & control
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Qualitative Research
  • Self Care / psychology
  • Self Efficacy
  • Surveys and Questionnaires / standards*
  • Victoria