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Development and Validation of a Chronic Obstructive Pulmonary Disease-Specific Health Literacy Scale (COPD-HLS)
1Gazi University Hospital, Internal Medicine Intensive Care Unit, Nurse, Ankara.
Computers, Informatics, Nursing : CIN
|May 22, 2026
Summary
A new tool, the COPD-HLS, effectively measures health literacy (HL) in patients with chronic obstructive pulmonary disease (COPD). This validated instrument helps identify individuals needing support for better disease self-management.
Area of Science:
- Respiratory Medicine
- Health Sciences
- Psychometrics
Background:
- Health literacy (HL) is vital for chronic obstructive pulmonary disease (COPD) patient self-care and management.
- A specific, validated instrument to assess HL in COPD patients was previously unavailable.
Purpose of the Study:
- To develop and validate a disease-specific instrument for assessing health literacy in COPD patients.
- To provide a reliable tool for nurses to identify and support patients with low health literacy.
Main Methods:
- Methodological study involving COPD patients to develop the COPD Health Literacy Scale (COPD-HLS).
- Content validity assessed by 10 experts; item pool reduced based on I-CVI.
- Exploratory and Confirmatory Factor Analysis (EFA & CFA) used to determine structure and model fit; reliability assessed using Cronbach's alpha and ICC.
Main Results:
- The COPD-HLS demonstrated strong content validity (overall S-CVI/Ave = 0.91).
- EFA identified a 3-factor structure (accessing/understanding info, using info/decision-making, self-management), explaining 67.21% of variance.
- CFA confirmed good model fit (RMSEA=0.060, CFI=0.985, TLI=0.981); high reliability (Cronbach's alpha 0.75-0.93, ICC=0.813) and test-retest stability.
Conclusions:
- The COPD-HLS is a valid and reliable instrument for assessing health literacy in COPD patients.
- This scale can assist healthcare professionals, particularly nurses, in tailoring educational and self-management interventions.
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