The Treatment Burden for Multimorbidity Scale: A Development and Psychometric Validation Study.
Kyoung Suk Lee, Jihyang Lee, Minji Kim and 1 others
PMID 41833542WHAT IT FOUND
A 12-item scale for patients managing several chronic conditions scored consistently and matched other burden measures, but its two-part structure did not fit perfectly and needs more testing.
Key findings
01The TBMS total scale had Cronbach's alpha of 0.93, and its healthcare tasks and impacts subscales had alpha of 0.90 and 0.88.
02TBMS total scores were positively correlated with disease burden and with the MTBQ, and negatively correlated with self-care.
03Over 6 months, reduced TBMS scores were associated with improved self-care, physical function, and depressive symptoms, while increased scores showed worsening, with effect sizes of 0.14 to 0.29.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample came from an online convenience panel in South Korea, so results may not apply to other populations or to people without internet access. Participants were younger than typical multimorbidity samples, with mean age 53.1 years compared with median 62.6 years in another study, and very highly educated, with 99.4% having at least a high school degree. Confirmatory factor analysis showed only marginal model fit, so the two-factor structure needs replication. Test-retest reliability was not measured, so stability of scores over short intervals is unknown. 37.8% of participants were lost to 6-month follow-up, although baseline characteristics and TBMS scores were similar except for gender. Burden group cut points were derived by data-driven clustering and are sample-specific, not generalizable clinical thresholds. Some inter-item correlations were high, suggesting possible item redundancy.
Declared interests
The study was funded by a National Research Foundation of Korea grant funded by the Korean government. Kyong Suk Lee is an Associate Editor for Nursing & Health Sciences and a co-author; the manuscript was managed by editors unaffiliated with the authors or their institution. The other authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that using the TBMS improves care or health outcomes. This study tested how the scale performs as a measurement tool, not whether clinicians acting on its scores change patient results.