Background: The efficacy of specific interventions also of mind-body medicine is also dependent on the patients' ability to engage in these interventions and to perceive and change health-affecting attitudes and behaviors. The aim was to validate a 13-item instrument to measure (1) the patients' perception of specific attitudes and behaviors that are assumed to have a negative influence on the health situation, (2) their intention to change them, and (3) the implementation of the intended changes in their life affairs. Patients and Methods: Anonymous cross-sectional survey among 512 patients with chronic pain conditions (mean age 42.6 ± 11.4 years; 58% women) using standardized instruments. Results: After the elimination of 4 items, an explorative factor analysis of the 9 remaining items indicated 2 factors that would explain 57% of the variance: Perceptions/Intentions (5 items; Cronbach's alpha = 0.75) and Ability/ Implementation (4 items; alpha = 0.77). Factor 2 correlated moderately to strongly with internal adaptive coping strategies (AKU) and situational awareness (CPSC), and weakly with mental health (SF-36), life satisfaction (BMLSS), and low depressive symptoms (BDI) and escape from illness (Escape). Factor 1 correlated weakly with age and adaptive coping strategies (AKU). Conclusions: The final 9-item Perception, Intention and Ability to Change (PIAC) scale was approved as a short, practicable and promising instrument, which should be further evaluated in the context of training and intervention programs, particularly with respect to its predictive relevance.

1.
World Health Organization (ed): Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, World Health Organization, 2009.
2.
Nowossadeck E: Population aging and hospitalization for chronic disease in Germany. Dtsch Arztebl Int 2012;109:151-157.
3.
Nowossadeck E: Demografische Alterung und Folgen für das Gesundheitswesen. Berlin, Robert Koch-Institut, 2012. http://edoc.rki.de/docviews/abstract.php?lang = ger&id = 2189.
4.
Robert Koch-Institut (ed): Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes. Gemeinsam von RKI und Destatis. www.gbe-bund.de/pdf/GESBER 2015.pdf, 2015.
5.
World Health Organization (ed): WHO. Global status report on noncommunicable diseases 2014. Geneva, World Health Organization, 2014. www.who.int/nmh/publications/ncd-status-report-2014/en/.
6.
Wolf-Kühn N, Morfeld M: Rehabilitationspsychologie. Wiesbaden, Springer Fachmedien, 2015.
7.
Schaeffer D, Haslbeck J: Bewältigung chronischer Krankheit; in Richter M, Hurrelmann K (eds): Soziologie von Gesundheit und Krankheit. Wiesbaden, Springer Fachmedien, 2016, pp 243-256.
8.
Fröhlich-Rüfenacht S, Rousselot A, Künzler A: Psychosoziale Aspekte chronischer Erkrankungen und deren Einfluss auf die Behandlung. Schweizerisches Medizin-Forum 2013;13:206-209.
9.
Ambrosio L, Senosiain García JM, Riverol Fernández M, Anaut Bravo S, Díaz De Cerio Ayesa S, Ursúa Sesma ME, Caparrós N, Portillo MC: Living with chronic illness in adults: a concept analysis. J Clin Nurs 2015;24:2357-2367.
10.
Stanton AL, Revenson TA, Tennen H: Health psychology: psychological adjustment to chronic disease. Annu Rev Psychol 2007;58:565-592.
11.
Whittemore R, Dixon J: Chronic illness: the process of integration. J Clin Nurs 2008;17:177-187.
12.
Büssing A, Ostermann T, Matthiessen P: Wer kontrolliert die Gesundheit? Dtsch Z Onkol 2008;40:150-156.
13.
Moss-Morris R, Petrie KJ, Weinman J: Functioning in chronic fatigue syndrome: do illness perceptions play a regulatory role? Br J Health Psychol 1996;1:15-25.
14.
Cameron LD, Moss-Morris R: Illness-related cognition and behavior; in Kaptein A, Weinman J (eds): Health Psychology: An Introduction. Oxford, Blackwell Publishers, 2004, pp 84-110.
15.
Hoch E, Mühlig S, Höfler M, Sonntag H, Pittrow D, Wittchen H-U: Raucherentwöhnung in der primärärztlichen Versorgung: Ziele, Design und Methoden der «Smoking and Nicotine Dependence Awareness and Screening (SNICAS)»-Studie 2004. www.qucosa.de/ recherche/frontdoor/?tx_slubopus4frontend%5Bid%5D = urn:nbn:de:bsz:14-qucosa-97918.
16.
Sheeran P, Webb TL: The intention-behavior gap. Soc Pers Psychol Compass 2016;10:503-518.
17.
Sheeran P: Intention-behavior relations: a conceptual and empirical review. Eur Rev Soc Psychol 2002;12:1-36.
18.
Rhodes RE, de Bruijn G-J: How big is the physical activity intention-behaviour gap? A meta-analysis using the action control framework. Br J Health Psychol 2013;18:296-309.
19.
Batra A: Therapie der Tabakabhängigkeit. Dtsch Arztebl 2011;108:555-564.
20.
US Department of Health and Human Services, Panel TU and DG: Treating tobacco use and dependence: 2008 update. www.ncbi.nlm.nih.gov/books/NBK63952/, 2008.
21.
Büssing A, Edelhäuser F, Weisskircher A, Fouladbakhsh JM, Heusser P: Inner correspondence and peacefulness with practices among participants in eurythmy therapy and Yoga: a validation study. Evid Based Complement Alternat Med 2011;2011:329023.
22.
Paul A, Lauche R, Cramer H, Altner N, Dobos G: An integrative day-care clinic for chronically ill patients: concept and case presentation. Eur J Integr Med 2012;4:E455-E459.
23.
Saha FJ, Brüning A, Barcelona C, Büssing A, Langhorst J, Dobos G, Lauche R, Cramer H: Integrative medicine for chronic pain: a cohort study using a process-outcome design in the context of a department for internal and integrative medicine. Medicine 2016;95:e4152.
24.
Fogg BJ: A behavior model for persuasive design; in: Persuasive ‘09. Proceedings of the 4th International Conference on Persuasive Technology. New York, Association for Computing Machinery 2009;40:1-40.
25.
Bandura A: Self-Efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977;84:191-215.
26.
Sheeran P, Maki A, Montanaro E, Avishai-Yitshak A, Bryan A, Klein WM, Miles E, Rothman AJ: The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: a meta-analysis. Health Psychol 2016;35:1178-1188.
27.
Rosenstock I: Historical origins of the Health Belief Model. Health Educ Behav 1974;2:328-335.
28.
Janz NK, Becker MH: The Health Belief Model: a decade later. Health Educ Behav 1984;11:1-47.
29.
Büssing A, Fischer J, Haller A, Heusser P, Ostermann T, Matthiessen PF: Validation of the Brief Multidimensional Life Satisfaction Scale in patients with chronic diseases. Eur J Med Res 2009;14:171.
30.
Bullinger M: Erfassung der gesundheitsbezogenen Lebensqualität mit dem SF-36-Health Survey. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2000;43:190-197.
31.
Bullinger M, Morfeld M: Der SF-36 Health Survey; in Schöffski PDO, Graf von der Schulenburg PDJ (eds): Gesundheitsökonomische Evaluationen. Berlin, Heidelberg, Springer, 2008, pp 387-402.
32.
Morfeld M, Bullinger M: Der SF-36 Health Survey zur Erhebung und Dokumentation gesundheitsbezogener Lebensqualität. Phys Med Rehabil Kurortmed 2008;18:250-255.
33.
Pollard CA: Preliminary validity study of the Pain Disability Index. Percept Mot Skills 1984;59:974.
34.
Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ: The Pain Disability Index: psychometric and validity data. Arch Phys Med Rehabil 1987;68:438-441.
35.
Tait RC, Chibnall JT, Krause S: The Pain Disability Index: psychometric properties. Pain 1990;40:171-182.
36.
Beck AT, Steer RA: Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol 1984;40:1365-1367.
37.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.
38.
Beck AT, Rial WY, Rickels K: Short form of Depression Inventory: cross-validation. Psychol Rep 1974;34:1184-1186.
39.
Büssing A, Walach H, Kohls N, Zimmermann F, Trousselard M: Conscious Presence and Self Control as a measure of situational awareness in soldiers - a validation study. Int J Ment Health Syst 2013;7:1.
40.
Walach H, Buchheld N, Buttenmüller V, Kleinknecht N, Schmidt S: Measuring mindfulness - the Freiburg Mindfulness Inventory (FMI). Personal Individ Differ 2006;40:1543-1555.
41.
Cohen S, Williamson G: Perceived stress in a probability sample of the United States; in Spacapam S, Oskamp S (eds): The Social Psychology of Health: Claremont Symposium on Applied Social Psychology 1988. Newbury Park, SAGE Publications, 1988.
42.
Büssing A, Keller N, Michalsen A, Moebus S, Dobos G, Ostermann T, Matthiessen PF: Spirituality and adaptive coping styles in German patients with chronic diseases in a CAM health care setting. J Complement Integr Med 2006;3: doi: 10.1186/1752-4458-7-1.
43.
Büssing A, Ostermann T, Matthiessen PF: Adaptive coping and spirituality as a resource in cancer patients. Breast Care 2007;2:195-202.
44.
Büssing A, Matthiessen PF, Mundle G: Emotional and rational disease acceptance in patients with depression and alcohol addiction. Health Qual Life Outcomes 2008;6:4.
45.
Schwarzer R, Jerusalem M: Skalen zur Erfassung von Lehrer- und Schülermerkmalen. Dokumentation der psychometrischen Verfahren im Rahmen der Wissenschaftlichen Begleitung des Modellversuchs Selbstwirksame Schulen. Berlin, Freie Universität Berlin, 1999.
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