Perceived Efficacy in Patient-Physician Interactions (PEPPI): Validation of an instrument in older persons

OBJECTIVE: To develop and validate a brief instrument the Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI) - to measure older patients' self-efficacy in obtaining medical information and attention to their medical concerns from physicians. DESIGN: Two consecutive validation surveys. SETTING: Eleven senior multipurpose centers 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, 57.7% female). MEASURES: The 10-item PEPPI, subscales of the Patient Satisfaction Questionnaire, the Medical Outcomes Study (MOS) Coping Scale, the Mastery Scale, and global self-reported health and restricted activity 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 hypothesized, 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 self-reported health (r = .42, P < .0001), education (r = .24, P = .01) and self-mastery (r = .29, P = .01) and negatively with restricted activity days (r = -.25, P = .01). PEPPI-5 demonstrated correlations similar in magnitude, direction, and statistical significance. CONCLUSION: In either the 5- or 10-item version, PEPPI is a valid and reliable measure of older patients' perceived self-efficacy in interacting with physicians. This instrument may be useful in measuring the impact of empowerment interventions to increase older patients' personal sense of effectiveness in obtaining needed health care.