Psychometric Evaluation of the Knowledge-Attitude-Practice Questionnaire for Health Professionals in Adult Functional...

Functional constipation is commonly encountered in adult healthcare, yet its clinical assessment is often limited by inconsistent recognition, insufficient nurse training, and the lack of a standardized instrument to assess how healthcare professionals integrate knowledge, attitudes, and practices into routine care. To address this gap, this study developed and psychometrically evaluated the Knowledge-Attitude-Practice Questionnaire for Health Professionals in Adult Functional Constipation Care (KAP-FC). Guided by the Knowledge-Attitude-Practice (KAP) framework, an initial item pool was generated through a literature review, theoretical analysis, and qualitative interviews, followed by two rounds of Delphi consultation with an interdisciplinary expert panel. The revised questionnaire was pre-tested and subsequently administered to 466 nurses from three tertiary hospitals in Nantong using stratified convenience sampling. Item screening was performed using the critical ratio method and item-total correlation analysis, while structural validity, content validity, internal consistency, and test-retest reliability were evaluated. Following item analysis, 28 items were retained, comprising 12 knowledge, 6 attitude, and 10 practice items. Exploratory factor analysis identified six factors that explained 72.344% of the total variance, with factor loadings ranging from 0.511 to 0.894. The overall Cronbach's α was 0.914, with dimension-specific Cronbach's α values ranging from 0.881 to 0.900. The intraclass correlation coefficient for test-retest reliability was 0.936, and the scale-level content validity index (S-CVI) was 0.929. These findings demonstrate that the KAP-FC questionnaire has satisfactory preliminary reliability and validity and may serve as a useful instrument for assessing healthcare professionals' knowledge, attitudes, and practices related to adult functional constipation care.