Development and validation of a knowledge, attitude and practice questionnaire of occupational therapy

Although occupational therapy (OT) plays a crucial role in enhancing patient outcomes, its utilization rate remains generally low. There is an urgent need for a validated assessment tool to identify gaps in the knowledge, attitude, and practice (KAP) of intensive care unit (ICU) healthcare workers and to guide targeted educational interventions. However, no validated questionnaire currently exists to evaluate OT-related KAP levels among ICU healthcare workers. This study aimed to develop and psychometrically validate a KAP questionnaire for occupational therapy among ICU healthcare workers. First, based on the KAP theory, an initial questionnaire was constructed through literature review, two rounds of Delphi expert consultation (n = 15), group discussion, and a pilot survey. Second, using convenience sampling, 390 ICU healthcare workers from 12 prefecture-level cities in Jiangsu Province were recruited for the questionnaire survey between January 2025 and March 2025. Item analysis, reliability, and validity tests were performed to refine the scale. The final questionnaire comprised 3 dimensions and 43 items. The scale-level content validity index (S-CVI) was 0.970, and the item-level content validity index (I-CVI) ranged from 0.800 to 1.000. Exploratory factor analysis (EFA) extracted 3 common factors, with factor loadings ranging from 0.575 to 0.969 on their respective dimensions, and the cumulative variance contribution rate was 82.456%. The inter-factor correlations ranged from-0.477 to 0.531. The overall Cronbach's alpha coefficient of the questionnaire was 0.980, and the Cronbach's alpha coefficients for the knowledge, attitude, and practice dimensions were 0.992, 0.989, and 0.968, respectively. The intraclass correlation coefficient (ICC) for test-retest reliability ranged from 0.805 to 0.965. The developed KAP questionnaire for OT among ICU healthcare workers demonstrates good reliability and validity, and can be used as a valid tool for assessing KAP levels and guiding targeted educational interventions in clinical practice.