Development and Psychometric Validation of a Multidimensional Ecological Model-Based Awareness Scale for Patients...

Area of Science:

• Nephrology
• Psychometrics
• Health Literacy

Background:

• Chronic kidney disease (CKD) awareness is critically low globally.
• Existing instruments lack comprehensive assessment across socioecological levels.
• A validated tool is needed to measure CKD awareness in patients with stage 3-4 CKD.

Purpose of the Study:

• To develop and psychometrically evaluate a multidimensional awareness scale for stage 3-4 CKD patients.
• To ground the scale in socioecological theory, assessing awareness from individual to systemic levels.
• To provide a tool for identifying awareness deficits and informing interventions.

Main Methods:

• Methodological study involving 908 patients with stage 3-4 CKD.
• Scale development included literature review, interviews, expert evaluation, and pilot testing.
• Exploratory and confirmatory factor analyses were used to validate the scale structure and psychometric properties.

Main Results:

• A 34-item scale (CKD-AS-34) was developed with a seven-factor structure and good model fit.
• The scale demonstrated excellent internal consistency (α=0.884, ω=0.889) and test-retest reliability (ICC=0.954).
• Convergent, discriminant, and criterion validity were confirmed, showing a strong correlation with health literacy.

Conclusions:

• The CKD-AS-34 is a novel, reliable, and valid multidimensional instrument for assessing CKD awareness.
• The scale effectively measures awareness across individual, interpersonal, community, and systemic levels.
• CKD-AS-34 can guide personalized patient education and targeted public health strategies.