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Development and Preliminary Psychometric Validation of the Gout Knowledge, Attitudes and Practices (G-KAP)
Binit Vaidya1, Jose Paulo Lorenzo2, Hanna Monica Z Sollano2,3
1National Center for Rheumatic Diseases, Kathmandu, Nepal.
Aim:
To develop and undertake preliminary psychometric validation of the Gout Knowledge, Attitudes and Practices (G-KAP) Questionnaire for patients with gout in multiple Asia-Pacific clinical settings.
Methods:
Six development experts and nine relevance experts reviewed the English 56-question instrument. Analyses included 312 baseline participants from 10 countries and 117 paired assessments; 149 participants formed an additional recruitment-wave subset. Language assistance involved oral explanation without a fixed translation script. We evaluated content relevance, keyed knowledge reliability, item-level stability, and exploratory structure using explicit coding and missing-data rules.
Results:
S-CVI/Ave was 0.998 across 68 rated rows. The 19-indicator knowledge score averaged 56.1% ± 20.3%; KR-20 was 0.770 and common-factor omega 0.764. Absolute-agreement single-measure ICC was 0.763 (95% bootstrap CI 0.635-0.857); mean retest increase was 2.34 percentage points (p = 0.037). Numeric attitude ICCs ranged 0.345-0.838. Among 303 complete cases for 38 exploratory indicators, full-matrix and common-factor parallel analyses suggested 7 and 11 dimensions. The seven-factor comparison model included two weak two-item factors and ambiguous cross-loadings.
Conclusion:
The English G-KAP shows strong expert-rated relevance and encouraging preliminary knowledge-score reliability. Oral-assistance variability, unequal recruitment and uncertain dimensionality limit interpretation. Cross-cultural validity, measurement invariance, attitude/practice composite scores and clinical effectiveness are unestablished. Standardized administration, linguistic adaptation and independent confirmatory evaluation are needed before cross-country comparison or subscale development.
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