Assessing biopsychosocial status in people living with HIV: validity, reliability, and responsiveness of BETY-BQ

BACKGROUND: Despite the quality of life (QoL) and biopsychosocial model gain importance in the management of people living with HIV (PLWH), there is lack of a suitable tool addressing the current demand. This longitudinal methodological study describes the validity, reliability, and responsiveness of the Bilişsel Egzersiz Terapi Yaklaşımı-Biopsychosocial Questionnaire (BETY-BQ), which was previously designed to assess biopsychosocial characteristics, including pain coping skills, functionality, fatigue, emotional state, sleep, sexuality, and sociability, resulting from chronic diseases in PLWH. METHODS: BETY-BQ was administered to a total of 150 PLWH in the outpatient clinics of two different hospitals. The Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Clinical Frailty Scale (CFS), and the FRAIL Questionnaire were used for the validity. For both reliability and responsiveness analyses, assessments were conducted in 30 PLWH. Reliability was evaluated by repeating the assessments at 1-week intervals, and responsiveness was assessed by re-administering the same scales at 3-month intervals. RESULTS: Moderate to high correlations were found between BETY-BQ and SF-36, HADS, CFS, FRAIL. The correlations between BETY-BQ and SF-36 subheadings ranged from rho=-0.497 to rho=-0.650, p < 0.001, while there were correlations with HADS-Anxiety (rho = 0.717, < 0.001), HADS-Depression (rho = 0.653, < 0.001), CFS (rho = 0.467, < 0.001), FRAIL (rho = 0.559, < 0.001). The score distribution refuted floor and ceiling effects. The reliability of BETY-BQ was confirmed by test-retest strategy (ICC = 0.951). The Cronbach’s α value was 0.943 for the test and 0.963 for the retest. The time-dependent change responsiveness of BETY-BQ was moderately correlated with the depression subheading of the HADS. CONCLUSIONS: BETY-BQ is as a valid and reliable instrument by which, multidisciplinary-interdisciplinary healthcare teams can evaluate the biopsychosocial features among PLWH in a holistic and practical manner. Preliminary findings also suggest its potential sensitivity to change, particularly concerning depressive symptoms; however, further studies are needed to establish its responsiveness fully. CLINICAL TRIAL NUMBER: Not applicable.