Inner Strength Questionnaire

Roux, Gayle M.
Dingley, Catherine E.
Journal Title
Journal ISSN
Volume Title

Abstract This instrument, the Inner Strength Questionnaire (ISQ), was developed through extensive qualitative and quantitative research on the phenomena of inner strength in women living with chronic health conditions. Drs. Gayle Roux and Catherine Dingley have conducted research over 20 years to improve outcomes for women living with breast cancer and other chronic health conditions through the development of a Middle Range Theory of Inner Strength in Women and the instrument to measure this concept. The theory assumes all humans have the potential and capacity for building inner strength. Research findings indicate inner strength contributes to quality of life (QOL) and is negatively correlated with depression. The Inner Strength Questionnaire (ISQ) instrument items were developed from research findings from five previous qualitative studies. Participants in these studies included women with chronic health conditions such as cancer, heart disease, organ transplantation, and multiple sclerosis. The studies included participants of varied racial background with representation from African American, Asian, Hispanic, and Caucasian women. The instrument is a comprehensive gender-specific measure of inner strength in women living with chronic health conditions. The Inner Strength Questionnaire (ISQ) is unique as it measures women’s inner strengths associated with social, physical, emotional, and spiritual needs of women living with a chronic health condition. Measurement of strengths via the ISQ creates a reliable strategy for nurses and other healthcare professionals to assess patients with chronic health conditions and tailor interventions that facilitate inner strength and enhanced QOL.

Psychometric testing of version three of the ISQ was developed from the results of two previous studies for instrument testing. The study sample for the third instrument testing was 281 women with self-reported chronic health conditions including heart disease, diabetes, cancer, and depression. The four factor structure was supported with a total of 27 items with loadings > 0.50. The reliability for the entire instrument (version 4) was 0.91. The instrument takes approximately 10-12 minutes to complete and is at the Flesch-Kincaide reading level of 4th grade. Therefore, it is a quick and reader-friendly measure. Results can be used to plan or test interventions utilized to enhance strength-building health outcomes in women. Measurement instruments used by researchers and clinicians for women living with chronic health conditions are central to advancing nursing science and practice. The ISQ is a public domain instrument. Permission to use the instrument is not required. However, the authors request you email Dr. Gayle Roux at Gmroux@gmailcom and Dr. Catherine Dingley at to assist us in the scientific tracking on the use and reliability of the ISQ in research. Investigators taking the time to share data summaries, scoring ranges, and reliability with Drs. Roux and Dingley will be acknowledged by an official letter for your contribution to the scientific advancement of research.

Inner Strength, Chronic health conditions, Women's health, Quality of life, Cancer