Factor analysis of the Korean version of the Illness Cognition Questionnaire for adolescents with chronic illness.
Dasuel Lee, Dae-Chul Jeong, Nack-Gyun Chung and 1 others
PMID 33314524WHAT IT FOUND
The Korean Illness Cognition Questionnaire generally holds up for teens with chronic illness, but one item on accepting limitations is confusing.
Teens interpret it as either positive resilience or negative resignation, so the wording needs clarification before it can reliably guide care.
Key findings
01The three-factor structure (perceived benefits, acceptance, helplessness) showed reasonable internal consistency (Cronbach's α .81) but only modest model fit indices (CFI .87, RMSEA .09) in the confirmatory analysis.
02Item 10 ('I have learned to accept the limitations imposed by my illness') had poor and ambiguous factor loadings, with some adolescents interpreting acceptance of limitations as positive resilience and others as negative resignation.
03Removing Item 10 slightly improved the model fit indices, but the authors recommend retaining it with revised wording to clarify the meaning of acceptance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The exploratory and confirmatory analyses used different groups with different diagnoses (blood cancer vs. mixed chronic conditions), which may affect the generalizability of the factor structure. The sample sizes for factor analysis were relatively small (n=126 and n=111). Content validity was established only by three nursing professors, without broader expert review. The ambiguous meaning of Item 10 limits the immediate clinical utility of the 'acceptance' subscale.
Declared interests
The authors declared no conflicts of interest. The study was funded by the National Research Foundation of Korea.
The easy way to misread this
Do not assume that a high score on the 'acceptance' subscale indicates healthy psychological adjustment. The study found that the key item measuring acceptance is interpreted differently by patients, with some viewing it as positive resilience and others as negative resignation. Clinical interviews are needed to clarify the meaning of this score.