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Development and psychometric evaluation of the knowledge scale for adults with congenitally malformed hearts
Helén Rönning1, Kristofer Arestedt, Niels Erik Nielsen
1Department of Medical and Health Sciences, Division of Nursing Science, Linköping University. helen.ronning@hhj.hj.se
Insights
A new scale, KnoCoMH, effectively assesses knowledge in adults with congenital heart disease. This tool helps evaluate understanding of medical treatments and daily life impacts for better patient care.
Area of Science:
- Cardiology
- Medical Education
- Psychometrics
Background:
- Adults with congenital heart disease (CHD) often have knowledge gaps about their condition.
- Current follow-up routines do not routinely assess CHD knowledge levels.
- Lack of validated, user-friendly tools hinders knowledge assessment, potentially impacting patient engagement in care.
Purpose of the Study:
- To develop and psychometrically evaluate a user-friendly knowledge scale for adults with CHD.
- To create a tool that assesses understanding of CHD and its effects on daily life.
- To facilitate routine knowledge assessment in clinical practice for improved patient outcomes.
Main Methods:
- The Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) was developed in two phases.
- Phase 1 involved expert and patient assessment for face and content validity.
- Phase 2 focused on psychometric evaluation, including item difficulty, internal consistency (KR-20), and test-retest reliability.
Main Results:
- The KnoCoMH comprises 46 items across four domains: General Knowledge, Medical Treatment, Endocarditis Prophylaxis, and Contraceptives and Pregnancy.
- Internal consistency (KR-20) ranged from 0.65 to 0.90 across domains, indicating acceptable reliability.
- Test-retest correlations were significant (0.50–0.67, P < .01), and item difficulty varied, with a mean of 0.56.
Conclusions:
- The KnoCoMH demonstrates acceptable psychometric properties for assessing knowledge in adults with CHD.
- The scale is suitable for evaluating knowledge and its association with other outcomes in this population.
- Further research is recommended to establish construct validity, predictive validity, and responsiveness.
Background And Research Objective:
Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts.
Participants And Methods:
The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability.
Results:
The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy.
Conclusions:
The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.
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