Development and validation of a self-management questionnaire for people living with HIV in low- and middle-income countries (HIV-SM LMIC tool)

Dadi, Tegene Legese; Koekebakker, Hanneke; Medhin, Girmay; Spigt, Mark

doi:10.1186/s12879-025-10876-9

Table 3 First round validation of HIV-SM LMIC tool and items selection

From: Development and validation of a self-management questionnaire for people living with HIV in low- and middle-income countries (HIV-SM LMIC tool)

Item Code	Participants’ qualitative judgment	Item clarity scores				Relevance CVI				Final decision and reasons for deleted items
Item Code	Participants’ qualitative judgment	N	Kappa²	FVI¹	FVR²	N	Kappa²	CVI¹	CVR³	Final decision and reasons for deleted items
CCS1	Revise: make more general question specific to HIV	51	Fair	0.57	0.14	48	Excellent	0.90	0.79	Keep and revise
CCS2	Revise: include examples of side effects	52	Good	0.63	0.27	48	Excellent	0.98	0.96	Keep and revise
CCS3	Remove: OI asked in later questions	52	Fair	0.56	0.12	47	Excellent	0.87	0.74	Delete: Qualitative suggestion and expert patient CVI scores < 0.80
CP1	Revise: It should focus on availability of the services	52	Excellent	0.83	0.65	46	Excellent	0.98	0.96	Keep and revise
CP2	Revise: physical access to HF	47	Good	0.64	0.28	44	Excellent	0.86	0.73	Delete: Distance is highly subjective and relative and expert CVI scores < 0.80
CP8	Revise	51	Excellent	0.75	0.49	47	Excellent	0.85	0.7	Delete: low CVI score (0.38) by expert patients & item measures more of structural problems of HF
CP9	Remove	50	Good	0.66	0.32	44	Excellent	0.80	0.59	Delete: Qualitative suggestion, low CVI scores (< 0.80) by HPs and expert patient
CS1	Remove: may resonate stigma	51	Good	0.63	0.25	46	Excellent	0.85	0.69	Delete: Qualitative suggestion and may be perceived as stigmatizing question
CS2	Revise: may resonate stigma	50	Excellent	0.80	0.6	45	Excellent	0.87	0.73	Delete: May be perceived as stigmatizing question and low CVI score (0.80) by participants
CS3	Keep	50	Excellent	0.80	0.6	47	Excellent	0.85	0.7	Keep and revise
CS5	Revise: specify the close person	52	Good	0.73	0.46	44	Excellent	0.93	0.86	Keep and revise
CSN6	Remove: redundancy CS3	46	Excellent	0.89	0.78	45	Excellent	0.87	0.73	Delete: Qualitative suggestion, low CVI score by expert patients (< 0.80), and redundancy with CS3
CIFN1	Keep	52	Good	0.73	0.46	48	Excellent	0.90	0.79	Delete: Very low CVI score by patients (< 0.80) and may create wrong impression on patients
CIF2	Keep	51	Good	0.65	0.29	48	Excellent	0.92	0.83	Keep and revise
CIF3	Revise: phrasing of the question	52	Excellent	0.79	0.58	46	Excellent	0.83	0.65	Keep and revise
CIF5	Remove: Might have different meaning	52	Excellent	0.88	0.77	45	Excellent	0.93	0.87	Delete: Qualitative suggestion and might have different meaning by expert patients
CIF6	Keep	52	Excellent	0.88	0.77	47	Excellent	0.98	0.96	Keep and revise
PKB3	Revise: mention examples	52	Excellent	0.88	0.77	46	Excellent	0.98	0.96	Keep and revise
PKB4	Revise: mention examples-	51	Excellent	0.94	0.88	48	Excellent	0.98	0.96	Keep and revise
PKB6	Keep	52	Excellent	0.85	0.69	47	Excellent	0.94	0.87	Keep and revise
PKB7	Keep	52	Excellent	0.87	0.73	47	Excellent	0.89	0.79	Delete: Low CVI score by expert patients (< 0.80)
PKB8	Remove: It may give wrong meaning to patients	52	Excellent	0.88	0.77	47	Excellent	0.89	0.79	Delete: Qualitative suggestion, low CVI patient scores (< 0.80) and can give wrong meaning to patients
PKB9	Remove: It may give wrong meaning to patients	52	Excellent	0.87	0.73	48	Excellent	0.88	0.75	Delete: Qualitative suggestion, low CVI patient scores (< 0.80) and can give wrong meaning to patients
PR1	Keep	51	Excellent	0.86	0.73	48	Excellent	0.92	0.83	Delete: Redundancies of concepts & low CVI score (< 0.80) by expert patients
PR8	Keep	52	Excellent	0.92	0.85	48	Excellent	0.96	0.92	Keep and revise
PR10	Keep	51	Excellent	0.84	0.69	47	Excellent	0.89	0.79	Keep and revise
PRN11	Keep	51	Excellent	0.94	0.88	47	Excellent	0.96	0.91	Keep and revise
PRN12	Remove	52	Excellent	0.90	0.81	47	Excellent	0.91	0.83	Delete: Qualitative suggestion, low CVI patient scores (< 0.80) & can give wrong meaning to patients
PRN13	Keep	49	Excellent	0.86	0.71	47	Excellent	0.94	0.87	Delete: Redundancies of concepts with other items and lowest CVI scores (< 0.80) by expert patient
PSF1	Keep	52	Excellent	0.92	0.85	47	Excellent	0.91	0.83	Keep and revise
PSF3	Keep	52	Excellent	0.87	0.73	46	Excellent	0.91	0.83	Keep and revise
PSF6	Remove	51	Excellent	0.84	0.69	46	Excellent	0.87	0.74	Delete: Qualitative suggestion and it might wrongly be interpreted by patients
PSR1	Revise	50	Excellent	0.80	0.6	46	Excellent	0.93	0.87	Keep and revise
PSR2	Keep	49	Good	0.71	0.43	44	Excellent	0.89	0.77	Keep and revise
PSR4	Keep	50	Excellent	0.88	0.76	44	Excellent	0.93	0.86	Keep and revise
PSR5	Revise: add justification	51	Good	0.75	0.49	46	Excellent	0.85	0.69	Keep and revise
PSR8	Keep	52	Excellent	0.79	0.58	47	Excellent	0.91	0.83	Delete: Redundancies of concepts with other items and lowest CVI scores (< 0.80) by expert patient
PSR12	Revise: Consult expert without stopping the treatment	52	Excellent	0.94	0.88	47	Excellent	0.98	0.96	Keep and revise
PSR14	Revise: phrasing of the questions	50	Excellent	0.88	0.76	43	Excellent	0.95	0.91	Keep and revise
PSR18	Revise: mention examples—patience, calmness	51	Excellent	0.92	0.84	47	Excellent	0.94	0.87	Keep and revise
PSR19	Remove: redundant with other specific questions	52	Excellent	0.79	0.58	46	Excellent	0.87	0.74	Delete: Qualitative suggestion, low CVI scores (< 0.80) by expert patients and redundancies of concepts
PSR23	Keep	52	Excellent	0.83	0.65	46	Excellent	0.87	0.74	Keep and revise
PSR28	Remove: might transmit wrong message	52	Excellent	0.85	0.69	47	Excellent	0.89	0.79	Delete: Qualitative suggestion might be wrongly interpreted by patients and low CVI score (< 0.80)
PSMB1	Revise: Change the question to responsibility	51	Excellent	0.82	0.65	46	Excellent	0.89	0.78	Keep and revise
PSMB2	Keep	50	Excellent	0.80	0.6	44	Excellent	0.91	0.82	Keep and revise
PSMB4	Keep	52	Excellent	0.88	0.77	47	Excellent	0.89	0.79	Keep and revise
PSMB7	Keep	52	Excellent	0.92	0.85	45	Excellent	0.91	0.82	Keep and revise
PSMB8	Revise: add phrase what available at home?	51	Excellent	0.86	0.73	46	Excellent	0.85	0.69	Keep and revise
PSMB9	Remove	50	Excellent	0.80	0.6	46	Excellent	0.85	0.69	Delete: Qualitative suggestion and it might be discriminating question
PSMB10	Remove: redundancy PSMB2	43	Excellent	0.84	0.67	40	Excellent	0.88	0.75	Delete: Redundancies with another item (PSMB2)
PSMB12	Keep	50	Excellent	0.76	0.52	43	Excellent	0.84	0.67	Keep and revise
PSMB14	Keep	51	Excellent	0.90	0.8	46	Excellent	0.98	0.96	Keep and revise
PSMB15	Revise: mention examples	50	Excellent	0.90	0.8	45	Excellent	0.91	0.82	Keep and revise
PSMB19	Revise: mention examples	51	Excellent	0.82	0.65	44	Excellent	0.98	0.95	Keep and revise
PSMB20	Remove: might reduce facility visit	51	Excellent	0.78	0.57	45	Excellent	0.96	0.91	Delete: Qualitative suggestion and might be wrongly interpreted as it may reduce facility visits
PSMB21	Keep	50	Excellent	0.98	0.96	44	Excellent	1.00	1	Keep and revise
PSMB22	Keep	50	Excellent	0.96	0.92	46	Excellent	0.96	0.91	Keep and revise
PSMB23	Keep	49	Excellent	0.90	0.8	45	Excellent	0.89	0.78	Keep and revise
PSMB24	Keep	51	Excellent	0.94	0.88	44	Excellent	0.98	0.95	Keep and revise
HS1	Remove	49	Excellent	0.78	0.55	46	Excellent	0.76	0.52	Delete: Qualitative suggestion, low CVI score (< 0.80) by expert patient and not adequate to measure quality of life
HS3	Remove	49	Good	0.69	0.39	45	Excellent	0.76	0.51
HS4	Remove	51	Excellent	0.88	0.76	46	Excellent	0.96	0.91
HSN5	Remove	50	Good	0.74	0.48	46	Excellent	0.85	0.69
			S-FVI/Ave³ = 0.82				S-CVI/Ave³ = 0.90
			S-FVR⁴ = 0.64				S-CVR⁴ = 0.81

¹I-CVI = Item Content Validity Index
²Kappa, described by Cicchetti and Sparrow (1981) and Fleiss (1981): Fair k = 0.40–0.59; – Good k = 0.60–0.74; and Excellent k > 0.74
³CVR = Content Validity Ratio
⁴S-CVI/Ave = Overall Scale CVI via Averaging calculation method
Overall Scale CVR via Averaging calculation method

Back to article page

ISSN: 1471-2334

Contact us

General enquiries: journalsubmissions@springernature.com

BMC Infectious Diseases

Contact us