Fenwick Eva K, Xie Jing, Rees Gwyn, Finger Robert P, Lamoureux Ecosse L
Centre for Eye Research Australia, University of Melbourne, The Royal Victorian Eye and Ear Hospital, East Melbourne Victoria, Austrailia.
PLoS One. 2013 Dec 3;8(12):e80593. doi: 10.1371/journal.pone.0080593. eCollection 2013.
In patients with Type 2 diabetes, to determine the factors associated with diabetes knowledge, derived from Rasch analysis, and compare results with a traditional raw scoring method.
RESEARCH DESIGN & METHODS: Participants in this cross-sectional study underwent a comprehensive clinical and biochemical assessment. Diabetes knowledge (main outcome) was assessed using the Diabetes Knowledge Test (DKT) which was psychometrically validated using Rasch analysis. The relationship between diabetes knowledge and risk factors identified during univariate analyses was examined using multivariable linear regression. The results using raw and Rasch-transformed methods were descriptively compared.
181 patients (mean age±standard deviation = 66.97±9.17 years; 113 (62%) male) were included. Using Rasch-derived DKT scores, those with greater education (β = 1.14; CI: 0.25,2.04, p = 0.013); had seen an ophthalmologist (β = 1.65; CI: 0.63,2.66, p = 0.002), and spoke English at home (β = 1.37; CI: 0.43,2.31, p = 0.005) had significantly better diabetes knowledge than those with less education, had not seen an ophthalmologist and spoke a language other than English, respectively. Patients who were members of the National Diabetes Service Scheme (NDSS) and had seen a diabetes educator also had better diabetes knowledge than their counterparts. Higher HbA1c level was independently associated with worse diabetes knowledge. Using raw measures, access to an ophthalmologist and NDSS membership were not independently associated with diabetes knowledge.
Sociodemographic, clinical and service use factors were independently associated with diabetes knowledge based on both raw scores and Rasch-derived scores, which supports the implementation of targeted interventions to improve patients' knowledge. Choice of psychometric analytical method can affect study outcomes and should be considered during intervention development.
在2型糖尿病患者中，确定通过拉施分析得出的与糖尿病知识相关的因素，并将结果与传统的原始评分方法进行比较。
这项横断面研究的参与者接受了全面的临床和生化评估。使用糖尿病知识测试（DKT）评估糖尿病知识（主要结果），该测试通过拉施分析进行了心理测量学验证。使用多变量线性回归研究糖尿病知识与单变量分析中确定的危险因素之间的关系。对原始方法和拉施转换方法的结果进行了描述性比较。
纳入了181名患者（平均年龄±标准差=66.97±9.17岁；113名（62%）男性）。使用拉施得出的DKT分数，受教育程度较高者（β=1.14；置信区间：0.25，2.04，p=0.013）；看过眼科医生者（β=1.65；置信区间：0.63，2.66，p=0.002），以及在家说英语者（β=1.37；置信区间：0.43，2.31，p=0.005）的糖尿病知识分别明显优于受教育程度较低、未看过眼科医生且在家说英语以外语言的患者。参加国家糖尿病服务计划（NDSS）并看过糖尿病教育者的患者的糖尿病知识也优于其对应者。较高的糖化血红蛋白（HbA1c）水平与较差的糖尿病知识独立相关。使用原始测量方法，看眼科医生的机会和NDSS会员资格与糖尿病知识无独立相关性。
社会人口统计学、临床和服务使用因素基于原始分数和拉施得出的分数均与糖尿病知识独立相关，这支持实施有针对性的干预措施以提高患者知识。心理测量分析方法的选择会影响研究结果，在干预措施制定过程中应予以考虑。
