Development and validation of a questionnaire assessing the perceived control in health care among older adults with care needs in the Netherlands.
OBJECTIVE
In response to the increased emphasis placed on older people's self-reliance in many welfare societies, we aimed to develop and validate a measurement instrument, assessing perceived control in health care among older adults with care needs. The target group consists of older people who live (semi-)independently and use professional health care, with or without informal care.


METHODS
Phase I (development) of the study consisted of the construction of the instrument based on the input from a variety of stakeholders. Phase II (validation) entailed a quantitative study in a sample of 247 respondents selected from the Longitudinal Aging Study Amsterdam, to assess the instrument's construct validity (structural validity and hypotheses testing) and reliability (internal consistency).


RESULTS
The questionnaire consists of 29 items, related to organizing professional care, communication with care professionals, health management in the home situation, planning (more) complex care in the future, and perceived support from the social network. Based on a factor analysis, we identified three subscales: (I.) 'perceived personal control in health care'; (II.) 'anticipated personal control regarding future health care'; and (III.) 'perceived support from the social network,' with internal consistencies varying from Cronbach's α = .71 to .90. Factor I was associated with mastery, self-efficacy, self-esteem (r = .31-.35) and factor III with social loneliness (r = -.42). Factor II correlated less strongly with mastery, self-efficacy, and self-esteem (r < .30).


CONCLUSIONS
Our questionnaire revealed sufficient construct validity and internal consistency. The instrument provides a basis for further quantitative research regarding control, especially in relation to health care-related outcomes.
Department of Epidemiology and Biostatistics, EMGO Institute of Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands. c.claassens@vumc.nl.
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Claassens
Department of Epidemiology and Biostatistics, EMGO Institute of Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
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Terwee
Department of Epidemiology and Biostatistics, EMGO Institute of Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.|Department of Psychiatry, VU University Medical Centre, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
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Deeg
Department of Sociology, VU University, De Boelelaan 1081, 1081 HV, Amsterdam, The Netherlands.
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Broese van Groenou
Department of Medical Humanities, EMGO Institute of Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
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Widdershoven
Department of Epidemiology and Biostatistics, EMGO Institute of Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.|Department of Psychiatry, VU University Medical Centre, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.|Department of Sociology, VU University, De Boelelaan 1081, 1081 HV, Amsterdam, The Netherlands.
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Huisman
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003142:Communication; D003695:Delivery of Health Care; D005163:Factor Analysis, Statistical; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009426:Netherlands; D011788:Quality of Life; D015203:Reproducibility of Results; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*
Health care; Older adults; Perceived control; Questionnaire; Validation