IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, South Australia, Australia.
Persistent Pain Research Group, Hopwood Centre for Neurobiology, South Australia Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.
PLoS One. 2023 Sep 29;18(9):e0286114. doi: 10.1371/journal.pone.0286114. eCollection 2023.
Many people with osteoarthritis hold beliefs that physical activity is unhelpful or dangerous for their joints, despite high-level evidence suggesting otherwise. Recent advances in scientific understanding of osteoarthritis have led to new treatments that target an individual's understanding both of their condition and the importance of best-practice management strategies, such as physical activity. Conceptual change has been proposed as an important mechanism by which cognitive interventions, such as pain science education, may reduce pain and improve function. There are currently no specific assessments of osteoarthritis conceptualisation to determine the effectiveness of cognitive interventions in effecting conceptual change in people with knee osteoarthritis. Therefore, we aimed to develop an item bank, as the first phase of developing a questionnaire to assess people's conceptualisations about their knee osteoarthritis and the role of physical activity in managing their osteoarthritis. Using a guideline-informed mixed method design, a panel of experts identified domains relevant to conceptualisation about knee osteoarthritis and physical activity (knowledge, beliefs, understanding) based upon available evidence. The panel created 33 provisional items. Qualitative and quantitative pretesting were used to explore how people with knee osteoarthritis understood the provisional items. Eighteen people with knee osteoarthritis completed cognitive interviews about their comprehension of the wording/grammar of each provisional item. The provisional item bank was field tested with 100 people with knee osteoarthritis. Readability was adequate with a Flesch reading ease score of 57.7. Although 14.7% used the 'Strongly agree' response option, only 3.4% of responses used the 'Strongly disagree' option, suggesting possible response bias. Predictive quality testing identified relevant modifications to the questionnaire instructions. The panel of experts appraised the qualitative data to assess whether and how items should be modified to address the problems identified, resulting in a final item bank of 45 items that can be evaluated for psychometric properties in future research.
许多骨关节炎患者认为体育活动对关节无益或危险，尽管高水平证据表明并非如此。最近对骨关节炎的科学认识的进展导致了新的治疗方法，这些方法针对个体对自身状况和最佳管理策略（如体育活动）的重要性的理解。概念转变已被提议为认知干预（如疼痛科学教育）可能减轻疼痛和改善功能的重要机制。目前尚无针对骨关节炎概念化的特定评估来确定认知干预在膝骨关节炎患者中引起概念转变的效果。因此，我们旨在开发一个项目库，作为开发一种评估人们对膝骨关节炎的概念化及其在管理骨关节炎中体育活动作用的问卷的第一阶段。使用指南指导的混合方法设计，专家组根据现有证据确定了与膝骨关节炎和体育活动的概念化相关的领域（知识、信念、理解）。专家组创建了 33 个暂定项目。定性和定量预测试用于探索膝骨关节炎患者如何理解暂定项目。18 名膝骨关节炎患者完成了有关他们对每个暂定项目措辞/语法的理解的认知访谈。暂定项目库在 100 名膝骨关节炎患者中进行了现场测试。可读性适中，Flesch 阅读舒适度评分为 57.7。尽管 14.7%的人使用“非常同意”的回答选项，但只有 3.4%的人使用“非常不同意”的回答选项，这表明可能存在回答偏差。预测质量测试确定了问卷说明的相关修改。专家组评估了定性数据，以评估是否以及如何修改项目以解决已确定的问题，从而形成了最终的 45 个项目库，这些项目库可以在未来的研究中评估其心理测量特性。
