Background: In a time of ageing populations, examination of the ability of multimorbid patients to achieve wellbeing 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 fulflment of substantive needs, far less research has investigated the quality of production functions (being in control, avoiding a loss frame, and efciency) to achieve wellbeing. 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 fulflment of production needs to achieve well-being. Methods: The 12-item SPF-Q was used to assess the quality of production functions via the fulflment 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 flled 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. Confrmatory factor analyses revealed good indices of ft for the instrument. As indicated by the high reliability coefcient, the scale also showed good internal consistency. We found support for construct validity through signifcant 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.

Quality of production functions, Social production functions, Production needs, Substantive needs, Multimorbidity, Control, Loss, Efciency, SPF-Q
dx.doi.org/10.1186/s12955-020-01573-z, hdl.handle.net/1765/133328
Health and Quality of Life Outcomes
Erasmus School of Health Policy & Management (ESHPM)

Nieboer, A.P, & Cramm, J.M. (2020). Validation of the SPF-Q, an instrument to assess the quality of production functions to achieve well-being, among multimorbid patients. Health and Quality of Life Outcomes. doi:10.1186/s12955-020-01573-z