[Self management in chronically ill adolescents: development of a short questionnaire]

Behavioural interventions in chronically ill adolescents aim to improve disease-related self-management. The study presents a short questionnaire for examining the self-management strategies in paediatric patients with obesity, asthma, type I diabetes or atopic eczema.

For each indication, six favourable disease management strategies were identified: adherence to the subjective body perception, avoidance of trigger factors, adequate control of one's own behaviour, appropriate emergency treatment, and regular prolonged treatment including, depending on the disease at hand, adherence to alimentation. For each indication a "disease management" scale with six items was constructed. Psychometric properties (item statistics, reliability) were examined among 416 adolescents. Participants were diagnosed at least with one chronic illness and took part in an inpatient rehabilitation programme in a German rehabilitation clinic.

For the scale obesity (KM-KJ-Adi) (n=192) difficulty of the items was 0.30-0.43, discrimination was 0.32-0.57 and Cronbach's alpha was 0.72. For the scale asthma (KM KJ AB) (n=164) difficulty of the items was 0.43-0.65, discrimination was 0.29-0.52 and Cronbach's alpha was 0.70. For the scale diabetes (KM-KJ-DM1) (n=78) difficulty of the items was of 0.42-0.74, discrimination was of 0.25-0.87 and Cronbach's alpha was 0.68. For the scale atopic eczema (KM-KJ-AE) (n=125) difficulty of the items was 0.31-0.71, discrimination was of 0.24-0.51 and Cronbach's alpha was 0.64.

Up to now, no economic, indication-specific and reliable questionnaire exists for assessing the competences of adolescents in their disease self-management. The presented questionnaire fills this gap, the indication-specific scales with only a few items show satisfactory psychometric results.

This questionnaire can be used as an instrument for self-management strategies in chronically ill adolescents. The responsiveness (change score) and validity have to be further investigated.