A measure for assessing patient perception of provider support for self-management of bipolar disorder


Evette J Ludman PhD Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle WA 98101, USA. Fax: (206) 287 2871; e-mail: ludman.e@ghc.org


Objectives:  Health care providers have an important role in acknowledging and supporting patients' self-management of chronic illnesses such as bipolar disorder. This report describes the development and evaluation of a brief measure for assessing patient perception of providers' support for self-management of bipolar disorder.

Methods:  A 10-item measure was developed combining generic items from an existing measure of providers' autonomy supportive versus controlling style with items specific to the self-management of bipolar disorder. The psychometric properties of the measure and its relation to clinical variables were evaluated in a sample of patients enrolled in an ongoing randomized intervention trial.

Results:  Data were obtained from 420 patients with a chart diagnosis of bipolar disorder (mean age=44, 68% female, 88% Caucasian). The proportion of missing responses for items ranged from 0 to 3%. Reliability coefficient alpha for the full scale was 0.94. Corrected item–total correlations for individual items ranged from 0.70 to 0.83. Factor analysis identified a single factor accounting for 67% of total variance. Factor loadings for individual items were all at least 0.75. The measure showed moderate positive correlations with measures of self-efficacy for managing bipolar disorder (r=0.34; p < 0.001), treatment satisfaction (r=0.63; p < 0.001), small negative correlations with measures of mania symptoms (r=–0.11; p < 0.03) and depressive symptoms (r=–0.09; p < 0.10).

Conclusions:  This measure shows good psychometric properties and good evidence for convergent and discriminant validity. It is promising for assessing an important aspect of care for bipolar disorder.