Objectives: There is a lack of scientifically validated tools to measure the knowledge attitude and practice (KAP) of informal caregivers for patients with pressure injury (PI). This study aims to develop a KAP Scale for Informal Caregivers of PI Patients and to evaluate its reliability and validity.
Methods: Based on the KAP theory framework and relevant literature, an initial pool of items was created through expert brainstorming sessions. The initial scale was formed after a Delphi expert consultation and a preliminary survey. From April to October 2023, a convenient sample of informal caregivers for PI patients was recruited from an inpatient department of the Third Xiangya Hospital of Central South University, as well as its associated community and nursing homes. The first round included 186 participants, and the second round included 213 participants, who were used for item analysis and reliability and validity testing. After a 3-week interval, 20 participants from the initial group were randomly selected for a retest to assess the test-retest reliability of the scale.
Results: The KAP Scale for informal caregivers of PI patients consists of 3 dimensions with 19 items. The overall internal consistency (Cronbach's α) of the scale was 0.916. The item-level content validity index (I-CVI) ranged from 0.826 to 1.000, and the scale level-content validity index/average (S-CVI/Ave) was 0.94. Exploratory factor analysis extracted 3 common factors, accounting for 64.643% of the total variance. Confirmatory factor analysis showed that the model fit the data well, with χ2/df=2.54, root mean square error of approximation (RMSEA)=0.085, comparative fit index (CFI)=0.920, and standardized root mean square residual (SRMR)=0.059.
Conclusions: The KAP scale for informal caregivers of PI patients demonstrates good reliability and validity and can be used to assess the KAP levels of informal caregivers regarding PI.
目的: 压力性损伤(pressure injury，PI)患者的非正式照顾者的认知及照顾行为水平暂缺科学性测量工具，本研究拟编制PI患者非正式照顾者知信行量表，并对其进行信效度检验。方法: 以知信行理论为框架，结合相关文献与专家头脑风暴，拟定量表初始条目池；经过德尔菲专家函询、预调查，形成初始量表。于2023年4至10月便利选取中南大学湘雅三医院住院部及其合作社区、长沙红枫康复医院的PI患者非正式照顾者进行调查，第1次纳入186名、第2次纳入213名进行量表项目分析及信效度检验；间隔3周，随机抽取已调查的20名重测，检验量表的重测信度。结果: PI患者非正式照顾者知信行量表共3个维度，19个条目。总量表内部一致性克龙巴赫α系数为0.916，量表所有条目水平的内容效度指数(item level-content validity index，I-CVI)为0.826~1.000，平均量表水平的内容效度指数(scale level-content validity index/average，S-CVI/Ave)为0.94。探索性因子分析提取3个公因子，累计方差贡献率为64.643%。验证性因子分析显示χ2/df=2.54，近似误差的均方根(root mean square error of approximation，RMSEA)=0.085，比较拟合指数(comparative fit index，CFI)=0.920，标准化均方根残差(standardized root mean square residual，SRMR)=0.059，模型与数据整体适配良好。结论: PI患者非正式照顾者知信行量表具有较好的信度和效度，可用于非正式照顾者PI知信行水平的评估。.
Keywords: informal caregiver; knowledge attitude and practice; pressure injury; reliability; scale; validity.