Development, Reliability, and Validity Testing of a KAP-Based Analgesic Assessment Scale

To develop a multidimensional KAP assessment scale evaluating patients' knowledge, attitude and practice toward analgesics, test its reliability and validity, and offer a standardized evaluation tool to carry out targeted health education and boost medication adherence among pain patients.

Methodological research of scale development and psychometric verification.

The initial item pool was established based on KAP theoretical framework, relevant literature review and Delphi expert consultation, followed by item screening to form the preliminary scale. A convenience sampling strategy was adopted. A total of 200 inpatients and outpatients from the pain department, oncology department, bone and joint surgery department, and spinal surgery department of a local tertiary hospital were enrolled to complete the questionnaire. Item analysis, internal consistency reliability test, content validity evaluation, and exploratory factor analysis were conducted to comprehensively verify the psychometric properties of the scale, with the statistical significance level set as α = 0.05.

The finalized scale contained 17 items covering three dimensions: 9 knowledge items, 5 attitude (belief) items and 3 practice (behavior) items. The overall Cronbach's α of the scale was 0.85. Deleting any single item could not raise the overall Cronbach's α, and the Cronbach's α of each dimension remained above 0.82. The item-level content validity index (I-CVI) of all items was ≥ 0.98, and the scale-level content validity index (S-CVI) reached 0.91. Exploratory factor analysis extracted five common latent factors, which jointly explained 71.16% of the total variance of all items.

The self-developed multidimensional KAP scale for patients' cognition, belief and behavior related to analgesics possesses satisfactory reliability, good construct validity and favorable clinical applicability. It can serve as a reliable quantitative evaluation instrument for pain-related patient assessment.

This standardized KAP scale can help clinical medical staff objectively identify patients' misunderstandings, negative attitudes and non-compliant behaviors regarding analgesic use. It supports personalized pain health education, standardizes refined pain management, optimizes patients' analgesic medication compliance, and ultimately improves the overall quality of clinical pain control.