# Validity and reliability of the Chinese beliefs about medicines questionnaire–specific in caregivers of children with Epilepsy

## TL;DR

This study validates a questionnaire to assess caregivers' beliefs about medicines for children with epilepsy in China.

## Contribution

The study adapts and validates the Chinese version of the BMQ-S for caregivers of children with epilepsy.

## Key findings

- The Chinese BMQ-S showed good reliability and validity for assessing medicine beliefs.
- About 63% of children with epilepsy were adherent to their medication.
- No significant link was found between BMQ-S scores and medication adherence.

## Abstract

There are 10.5 million children with epilepsy (CWE) around the world. Approximately 70% of people with epilepsy could become seizure-free with appropriate antiseizure therapy. Beliefs may play an important role in medication adherence according to the Health Belief Model. The Belief about Medicines Questionnaire–Specific (BMQ-S) was developed to assess individuals’ beliefs about medicines, yet few studies have examined its application among caregivers of CWE in China.

The study aimed to verify the validity and reliability of the Chinese BMQ-S among caregivers of CWE.

A cross-sectional study was conducted in West China Second University Hospital, Sichuan University, from June 2021 to May 2024. The Chinese version of the BMQ-S, originally validated for depression, was adapted for use in this study. After obtaining informed consent, participants were asked to complete a general information questionnaire and the Chinese BMQ-S. Reliability was assessed using McDonald’s omega in SPSS 26 (IBM Corporation, Armonk, NY, USA), and construct validity was evaluated using confirmatory factor analysis in Mplus 8.1 (Muthén & Muthén, Los Angeles, CA, USA). The Morisky Medication Adherence Scale was used to assess medication adherence of CWE. The relationship between BMQ-S and adherence was explored using the binary logistic regression analysis.

A total of 2,730 caregivers were recruited, of whom 2,405 (88.01%) completed the survey. The children of participants included 1,283 (53.35%) boys and 1,122 (46.65%) girls, ranging in age from 0.08 to 17.80 years. McDonald’s omega values were 0.808 for BMQ-necessity and 0.709 for BMQ-concern. Confirmatory factor analysis showed the following fit indices for the final two-factor model: comparative fit index = 0.975, Tucker–Lewis index = 0.964, standardized root mean square residual = 0.038, and root mean square error of approximation = 0.079. The results indicated that 1,513 CWE (62.91%) were adherent to their medication therapy and 892 (37.09%) were non-adherent. However, no statistically significant association was observed between BMQ-S scores and medication adherence.

The Chinese BMQ-S is a reliable and valid tool for assessing medicine beliefs among caregivers of CWE. Further studies are needed to explore the relationship between BMQ scores and antiseizure medicine adherence.