Department of Nursing, Daegu University, Daegu, Republic of Korea.
Department of Diabetes Education, Samsung Medical Center, Seoul, Republic of Korea.
Patient Educ Couns. 2018 Aug;101(8):1468-1476. doi: 10.1016/j.pec.2018.03.013. Epub 2018 Mar 13.
To develop and examine the psychometric properties of the Korean Health Literacy Scale for Diabetes Mellitus (KHLS-DM), and to establish reasonable cutoff scores.
Initially, 299 items were generated to measure diabetes-related words, numeracy, and information utilization. Content validity assessment and preliminary tests were conducted. After exploratory factor analysis (EFA) and Rasch analysis, the remaining 65 items were administered to a quota sample of 500 diabetic patients aged 40-74 years. The items were narrowed down to 58 items based on an item fit index. To obtain cutoff scores, Jaeger's method and the Bookmark method were employed.
A confirmatory factor analysis (CFA) was performed, and a three-factor model was supported (χ/df = 3.891, CFI = 0.92, TLI = 0.91, RMSEA = 0.04). The overall scores ranged from 0 to 58, and two cutoff points were established. The scale exhibited good internal consistency (Cronbach's α = 0.83).
The KHLS-DM is a reliable and valid measure with cutoff points to classify individuals into three groups (adequate, marginal, and inadequate).
The standard setting may be useful for researchers to validate health literacy measures in other countries and populations.
研制并检验《韩国糖尿病健康素养量表》（KHLS-DM）的心理测量学特性，并建立合理的截断分数。
最初生成了 299 个项目来测量与糖尿病相关的词汇、计算能力和信息利用。进行了内容效度评估和初步测试。在探索性因子分析（EFA）和 Rasch 分析后，对 500 名年龄在 40-74 岁的糖尿病患者进行了剩余 65 个项目的配额样本测试。根据项目拟合指数，将项目数量缩小到 58 个。为了获得截断分数，采用了 Jaeger 法和书签法。
进行了验证性因子分析（CFA），支持三因素模型（χ/df=3.891，CFI=0.92，TLI=0.91，RMSEA=0.04）。总分范围为 0 至 58，确定了两个截断点。该量表具有良好的内部一致性（Cronbach's α=0.83）。
KHLS-DM 是一种可靠有效的测量工具，具有截断点，可以将个体分为三组（足够、边缘和不足）。
标准设定可能对研究人员在其他国家和人群中验证健康素养测量工具有用。
