Multidimensional Assessment of Individuals with Parkinson's Disease: Development and Structure Validation of a Self-Assessment Questionnaire

Abstract

(1) Background: Several instruments are used to assess individuals with Parkinson's disease (PD). However, most instruments necessitate the physical presence of a clinician for evaluation, were not designed for PD, nor validated for remote application. (2) Objectives: To develop and validate a self-assessment questionnaire that can be used remotely, and to assess the respondents' health condition. (3) Methods: A questionnaire, so-called Multidimensional Assessment Questionnaire for Individuals with PD (MAQPD), was developed, administered remotely, and completed by 302 people with PD. MAQPD was validated using factor analysis (FA). The participants' level of impairment was estimated using factor loadings. The scale's accuracy was assessed estimating floor and ceiling effects and Cronbach's alpha. (4) Results: FA suggested classifying the questions into daily activities, cognition, and pain. The respondents did not have extremely severe impairment (most scores ranged from 100 to 180 points), and the factors with the lowest scores were cognition and pain. The instrument had no significant floor or ceiling effects (rates less than 15%), and the Cronbach's alpha value was larger than 0.90. (5) Conclusion: MAQPD is the only remote self-administered tool found in the literature capable of providing a detailed assessment of the general health status of individuals with PD.

Keywords: Parkinson’s disease; disease progression; multidimensional assessment questionnaire; patient monitoring; remote evaluation; self-assessment.

Figure 1

Data correlation matrix before FA.

Figure 2

Data correlation matrix after FA. The questions are numbered in accordance with the original questionnaire.

Figure 3

Correlation plots showing the correlation between variables of Factor 1 (A), Factor 2 (B), and Factor 3 (C), and the final scores.

Figure 4

Violin plot of the final scores.

Figure 5

Histogram and cumulative probability distribution function of final scores.

Figure 6

TreeMap of the questionnaire. The colors represent the most common scoring for each question. The higher the factor loading, the larger the area of the rectangle. Each factor has its own set of questions (1, 2 or 3).