Knowledge of Illness Questionnaire (KIQ-6)

Description

The Knowledge of Illness Questionnaire (KIQ-6) is a specialized assessment instrument developed to evaluate children’s and adolescents’ understanding of their illness. Originally developed by Bibace and Walsh (1980), the questionnaire is based on Jean Piaget’s theory of cognitive development and examines how children’s concepts of illness evolve according to their developmental stage. Rather than simply measuring factual knowledge, the KIQ-6 evaluates the level of cognitive understanding children have regarding the causes, mechanisms, consequences, and treatment of illness.

The KIQ-6 consists of six structured questions and is available in two age-specific versions:

• Children aged 6–12 years

• Adolescents aged 13–18 years

The questionnaire assesses participants’ understanding of their health condition by exploring their beliefs about illness causation, disease mechanisms, treatment, and recovery. It is frequently administered alongside disease-specific knowledge questionnaires, such as questionnaires assessing knowledge of cancer, diabetes, asthma, or other chronic medical conditions, providing a comprehensive evaluation of illness-related knowledge.

The KIQ-6 is widely used in pediatrics, pediatric psychology, child and adolescent psychiatry, health psychology, nursing, patient education, and clinical research investigating health literacy, treatment adherence, psychological adjustment, and self-management of chronic diseases among children and adolescents.

Data Analysis and Applications

Data collected using the KIQ-6 are analyzed using psychometric and statistical methods that evaluate children’s cognitive understanding of illness according to developmental theory.

Responses are classified according to the developmental framework proposed by Bibace and Walsh, which is based on Piaget’s stages of cognitive development. Responses are categorized into six progressively advanced conceptual levels:

• Phenomenalism

• Contamination

• Contagion

• Internalization

• Physiological Explanation

• Psychophysiological Explanation

Each response is scored using a 0–6 rating scale, where:

• 0 indicates a response that cannot be classified.

• 6 represents the highest level of illness understanding, corresponding to a sophisticated psychophysiological explanation.

Psychometric evaluation typically includes:

• Internal consistency, assessed using Cronbach’s alpha coefficient.

• Content validity.

• Construct validity, where applicable.

• Convergent, discriminant, and criterion validity, established through comparisons with other health literacy and illness knowledge instruments.

In research settings, KIQ-6 data are commonly analyzed using:

• Descriptive statistics, including means, standard deviations, frequencies, and percentages.

• Comparative analyses, such as independent-samples t-tests, Analysis of Variance (ANOVA), Mann–Whitney U tests, and Kruskal–Wallis tests, to compare knowledge levels across age groups and clinical populations.

• Correlation analyses, using Pearson and Spearman correlation coefficients to investigate relationships between illness knowledge, treatment adherence, quality of life, psychological adjustment, and disease management.

• Multivariate statistical techniques, including linear regression, logistic regression, mediation and moderation analyses, and Structural Equation Modeling (SEM) to identify predictors of illness knowledge and its influence on clinical and psychosocial outcomes.

Purpose

The primary purpose of the Knowledge of Illness Questionnaire (KIQ-6) is to provide a reliable assessment of the level of understanding that children and adolescents have regarding their illness while considering their stage of cognitive development.

More specifically, the questionnaire is designed to:

• identify deficiencies in illness-related knowledge;

• support individualized patient education programs;

• improve communication between healthcare professionals, children, and families;

• promote treatment adherence and self-management;

• evaluate the effectiveness of educational and psychoeducational interventions.

Furthermore, the KIQ-6 is widely used in pediatric research investigating the relationships between illness knowledge, psychological adaptation, health literacy, quality of life, and long-term management of chronic diseases.

Scoring

The KIQ-6 consists of six questions designed to evaluate children’s and adolescents’ conceptual understanding of illness.

Responses are scored according to the Bibace and Walsh developmental classification system, using a 0–6 scale, where higher scores indicate more advanced cognitive understanding of illness.

• Higher scores indicate greater illness knowledge, more mature understanding of disease mechanisms, treatment, and health management, as well as higher levels of health literacy.

• Lower scores indicate limited understanding of illness concepts and may suggest the need for additional patient education and family-centered educational interventions.

The instrument has demonstrated excellent content validity and high internal consistency, with a reported Cronbach’s alpha coefficient of 0.92, supporting its reliability for assessing illness knowledge in pediatric populations.

References

• Bibace, R., & Walsh, M. E. (1980). Development of Children’s Concepts of Illness. Pediatrics, 66(6), 912–917.

• Bibace, R., & Walsh, M. E. (1981). Children’s Conceptions of Illness. In Children’s Health Care.

• Liossi, C., & Hatira, P. (1999). Clinical Hypnosis versus Cognitive Behavioral Training for Pain Management with Pediatric Cancer Patients Undergoing Bone Marrow Aspirations. International Journal of Clinical and Experimental Hypnosis, 47(2), 104–116.

• Prokopiadou, D., Papadakaki, M., Roumeliotaki, T., Komninos, I. D., Bastas, C., Iatraki, E., et al. (2015). Translation and Validation of a Questionnaire to Assess the Diagnosis and Management of Dementia in Greek General Practice. Evaluation & the Health Professions, 38(2), 151–159.