Validation of the SPF-Q, an instrument to assess the quality of production functions to achieve well-being, among multimorbid patients

BACKGROUND: In a time of ageing populations, examination of the ability of multimorbid patients to achieve well-being has become increasingly important. Social production function theory is used to characterise people’s ability to achieve well-being. Whereas much research has examined the fulfilment of substantive needs, far less research has investigated the quality of production functions (being in control, avoiding a loss frame, and efficiency) to achieve well-being. Therefore, this study involved the development and validation of the Social Production Function-Quality of production functions (SPF-Q) instrument to assess the quality of production functions via the fulfilment of production needs to achieve well-being. METHODS: The 12-item SPF-Q was used to assess the quality of production functions via the fulfilment of production needs to achieve well-being among patients with multimorbidity from seven health care practices in the region of Tilburg, the Netherlands. A total of 216 patients filled in the questionnaire (55% response rate). To test the validity of the SPF-Q, we used structural equation modelling to specify a measurement model by loading each item on its respective latent factor, and we examined associations between production needs and other measures. RESULTS: Psychometric results clearly showed that the SPF-Q is a valid and reliable instrument for the assessment of the quality of production functions among multimorbid patients. Confirmatory factor analyses revealed good indices of fit for the instrument. As indicated by the high reliability coefficient, the scale also showed good internal consistency. We found support for construct validity through significant positive correlations between substantive and production well-being needs, as well as with overall well-being and life satisfaction. Moreover, production needs added to multimorbid patients’ overall level of well-being in addition to the substantive needs. CONCLUSION: This study clearly showed that the SPF-Q is a valid and reliable instrument for the assessment of production needs among multimorbid patients. Given that multimorbidity is becoming the leading threat to population health, such an instrument can help to improve the ability to achieve well-being in this vulnerable population.