抗凝知识工具（AKT）：在意大利人群中的进一步有效性证据。
Anticoagulation Knowledge Tool (AKT): Further evidence of validity in the Italian population.
机构信息
Health Professions Research and Development Unit, IRCCS Policlinic San Donato University Hospital, San Donato Milanese, Milan, Italy.
Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy.
出版信息
PLoS One. 2018 Aug 14;13(8):e0201476. doi: 10.1371/journal.pone.0201476. eCollection 2018.
INTRODUCTION
Oral Anticoagulation therapy (OAC) is highly effective in the management of thromboembolic disorders. An adequate level of knowledge is important for self-management and optimizing clinical outcomes. The Anticoagulation Knowledge Tool (AKT) was developed to assess OAC knowledge and caters for both patients prescribed direct oral anticoagulants or vitamin K antagonist (VKA). However, evidence regarding its psychometric proprieties, validity and reliability are unavailable in non-English speaking settings. For this reason, the aim of this study is to provide further evidence of validity for AKT and also developing an Italian AKT version (I-AKT) supported by evidence of validity and reliability.
METHODS
A multiphase study was conducted which included the following: cultural and linguistic validity; i.e. content validity; construct validity; reliability assessment. The Construct validity was performed using the contrasted group approach using three groups comprised of health care providers, patients and the general public. Furthermore, Exploratory Structural Equation Modelling (ESEM) was performed to confirm the mono-dimensional structure of the items in the AKT.
RESULTS
In construct validity phase 334 participants were enrolled. One-way ANOVA and post hoc analysis test demonstrated significant differences between the means knowledge scores of the three groups: 30.42±3.04 vs 23.45± 4.57 vs14.32±6.07 (Statistic F = 266.83; p < .001). ESEM analysis demonstrates the I-AKT mono-dimensionally structure with an explained variance of 56.42%. The scale also showed both good internal consistency reliability (Cronbach's α = 0.896) and test-retest reliability (r = 0.855).
CONCLUSION
This study developed and validated I-AKT with supporting evidence for validity and reliability. The study also confirms the mono-dimensional of the items in the AKT. This suggest that the instrument can be useful in non-English setting for knowledge assessment and in potentially developing patient education materials.
简介
口服抗凝治疗（OAC）在血栓栓塞性疾病的治疗中非常有效。为了进行自我管理和优化临床结果，具备足够的知识水平非常重要。抗凝知识工具（AKT）是为了评估 OAC 知识而开发的，适用于开处直接口服抗凝剂或维生素 K 拮抗剂（VKA）的患者。然而，在非英语环境下，其心理测量特性、有效性和可靠性的证据尚不可用。出于这个原因，本研究的目的是进一步提供 AKT 的有效性证据，并开发一个意大利语 AKT 版本（I-AKT），同时提供有效性和可靠性的证据支持。
方法
进行了一个多阶段的研究，包括以下内容：文化和语言的有效性，即内容有效性；结构有效性；可靠性评估。结构有效性是使用三个包含医疗保健提供者、患者和公众的对比组方法来进行的。此外，还进行了探索性结构方程建模（ESEM），以确认 AKT 项目的单维结构。
结果
在结构有效性阶段，共有 334 名参与者入组。单因素方差分析和事后分析检验表明，三组之间的知识得分均值存在显著差异：30.42±3.04 与 23.45±4.57 与 14.32±6.07（统计 F = 266.83；p <.001）。ESEM 分析表明，I-AKT 呈单维度结构，解释方差为 56.42%。该量表还具有良好的内部一致性信度（Cronbach's α = 0.896）和重测信度（r = 0.855）。
结论
本研究开发并验证了 I-AKT，具有有效性和可靠性的支持证据。该研究还证实了 AKT 项目的单维度结构。这表明该工具在非英语环境下可用于知识评估，并可能用于开发患者教育材料。
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