North Florida / South Georgia Veteran Healthcare System, Gainesville, FL, United States of America.
Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, FL, United States of America.
PLoS One. 2022 Sep 9;17(9):e0269488. doi: 10.1371/journal.pone.0269488. eCollection 2022.
Lack of awareness for chronic kidney disease (CKD), including end stage kidney disease (ESKD) and their management options is a major impediment to patients being able to select and use home dialysis therapies. While some instruments have been developed to measure CKD awareness, we lack validated instruments to evaluate patients' awareness of ESKD and dialysis modalities. This study is part of multipart project for developing and validating an ESKD-centric disease awareness questionnaire.
A team of specialty renal care experts developed a 45-items questionnaire encompassing the subdomains of General Kidney Knowledge, CKD Knowledge, and ESKD Knowledge. Item reduction analysis-specifically, calculation of item difficulty and item discrimination index scores-was used to items for further review and potential removal.
Index scores were reviewed in conjunction with consideration of theoretical and substantive item content to reduce the number of items in the questionnaire, resulting in a 32-item questionnaire, retaining 5/10 items in the general kidney knowledge subdomain, 14/21 items in the CKD knowledge subdomain, and 13/14 items in the ESKD knowledge subdomain. Retained items ranged from 0.19 to 0.79 on the difficulty index, and from 0.31 to 0.81 on the discrimination index. Scores for percent correct on the reduced questionnaire spanned 0% to 87.5% correct on the full scale, 0% to 100% correct on the General Knowledge subdomain, 0% to 100% on the CKD Knowledge subdomain, and 0% to 92.3% on ESKD Knowledge subdomain.
The questionnaire developed and refined in this study constitutes a patient disease awareness instrument that spans a range of difficulty, and yet shows strong ability to distinguish between patients with varying levels of disease awareness. This study is the first in part of a multistep project to addresses a gap in measuring ESKD specific knowledge. Accurate assessment of patients' disease awareness through a validated instrument can allow identification of knowledge domains leading to positive impacts on their healthcare decisions and improve targeted patient education efforts.
对慢性肾脏病（CKD），包括终末期肾病（ESKD）及其管理方案缺乏认识，是患者能够选择和使用家庭透析治疗的主要障碍。虽然已经开发了一些工具来测量 CKD 意识，但我们缺乏经过验证的工具来评估患者对 ESKD 和透析方式的意识。这项研究是开发和验证以 ESKD 为中心的疾病意识问卷的多部分项目的一部分。
一组专业肾脏护理专家开发了一个包含一般肾脏知识、CKD 知识和 ESKD 知识亚领域的 45 项问卷。通过特定的项目缩减分析——计算项目难度和项目区分指数得分——对项目进行进一步审查和潜在删除。
与考虑理论和实质性项目内容相结合，对指数得分进行了审查，以减少问卷中的项目数量，得到一个 32 项的问卷，保留了一般肾脏知识子领域的 5/10 项、CKD 知识子领域的 14/21 项和 ESKD 知识子领域的 13/14 项。保留的项目难度指数在 0.19 到 0.79 之间，区分指数在 0.31 到 0.81 之间。简化问卷的得分涵盖了完整量表的 0%到 87.5%正确、一般知识子领域的 0%到 100%正确、CKD 知识子领域的 0%到 100%正确以及 ESKD 知识子领域的 0%到 92.3%正确。
本研究中开发和精炼的问卷构成了一种患者疾病意识工具，涵盖了一系列难度，并且表现出了较强的区分不同疾病意识水平患者的能力。这项研究是多步骤项目的第一部分，旨在解决衡量 ESKD 特定知识的空白。通过经过验证的工具准确评估患者的疾病意识，可以确定对他们的医疗保健决策产生积极影响的知识领域，并改善有针对性的患者教育工作。
