Department of Medical and Health Sciences, Division of Nursing Science, Linköping University.
J Cardiovasc Nurs. 2013 May-Jun;28(3):228-37. doi: 10.1097/JCN.0b013e3182498785.
Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts.
The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability.
The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy.
The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.
患有先天性心脏畸形的成年人对其心脏状况存在知识空白，而且在随访过程中通常不会评估他们的知识水平。造成这种情况的一个原因是，很少有经过验证的、用户友好的问卷可以评估对先天性心脏病及其对日常生活影响的了解。如果不能识别出知识水平较低的情况，可能会导致那些没有积极参与治疗和护理自身心脏状况的动机不足且没有安全感的个体。因此，本研究的目的是开发和测试一种针对先天性心脏畸形成年人的知识量表。
先天性心脏畸形成年人知识量表（KnoCoMH）的开发和心理测量评估分为 2 个阶段：（1）初始版本的开发和评估，通过专家和先天性心脏畸形成年人对其进行内容有效性和表面有效性评估；（2）在先天性心脏畸形成年人中评估和完善 KnoCoMH，包括项目难度水平、内部一致性和重测信度。
开发和评估一种针对先天性心脏畸形成年人的知识量表的结果是，KnoCoMH 包括 4 个领域的 46 个项目：一般知识领域，克朗巴赫 α 系数为 0.68；治疗领域，克朗巴赫 α 系数为 0.74；心内膜炎预防领域，克朗巴赫 α 系数为 0.90；避孕和妊娠领域，克朗巴赫 α 系数为 0.65。所有 4 个领域的重测评估均显示出 0.50 到 0.67（P<.01）之间的显著相关性。项目难度差异较大，一般知识领域的平均值为 0.56，治疗领域为 0.62，心内膜炎预防领域为 0.33，避孕和妊娠领域为 0.48。
KnoCoMH 具有大多数包含的知识领域的可接受心理测量特性。它可用于评估先天性心脏畸形成年人的知识水平及其与其他结果的关系。然而，建议进一步研究以测试构念有效性、预测有效性和反应性。
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