Construct Validity and Reliability of the Arabic Version of Hypertension Knowledge-Level Scale Among Saudi Population

Abstract

BackgroundKnowledgeable people are more likely to follow their treatment plan and reduce hypertension morbidity and mortality. This study aimed to construct the validity and reliability of the Arabic version of the Hypertension Knowledge-Level Scale (HK-LS) among Saudis. MethodsThis cross-sectional questionnaire research targets hypertensives and non-hypertensives. Cronbach's alpha and Spearman's correlation matrix analysis measured the questionnaire's construct validity. Wilcoxon rank sum tests examined HK-LS tools' discriminant validity. A p<0.05 was considered significant. ResultsA total of 1424 responses were received. However, the 1419 individuals were evaluated after applying exclusion criteria. About 60% of the participants were female, with the most common age groups being 18-29 years (38.5%) and 40-49 years (24.0%). A personal history of hypertension was reported by 26.1%, and a family history of hypertension by 73.3% of the subjects. Cronbach's alpha for the whole HK-LS was 0.883, suggesting that the tool was reliable. All the items of the HK-LS questionnaire were significantly correlated with each other, except for a non-significant correlation between statements two and seven (r=0.05, p=0.091). The strongest correlations were apparent between items 19 and 20 (r=0.70, p<0.0001), items one and two (r=0.64, p<0.0001), and items 18 and 19 (r=0.56, p<0.0001). However, the weakest associations were reported among items two and six (r=0.06, p<0.05), items two and nine (r=0.07, p<0.05), and items one and 19 (r=0.07, p<0.05). The discriminant validity showed that a personal history of hypertension was associated with significantly higher scores of two HK-LS subscales, including definitions and complications. In addition, the overall knowledge score was significantly higher among participants with a positive history of hypertension among family and/or friends. ConclusionsThe Arabic version of the HK-LS was found to be a reliable and valid tool for measuring knowledge about hypertension among the Saudi population. This reliable instrument can assist medical professionals in establishing education programs.

Assessing knowledge about hypertension and identifying predictors of inadequate knowledge in Saudi Arabia: A cross-sectional study

“…The majority of participants (59.3%); (95% CI: 53.0%-66.0%) were classified as having inadequate knowledge about the disease and its management. These findings at the overall level are relatively similar to those of a previous Saudi study conducted by Abualnaja OS et al in Makkah and another recent study conducted by Alshammari SA et al to assess the validity and reliability of the HK-LS, where they reported an overall knowledge score of 70.2% and 68.5%, respectively [ 14 , 15 ]. On the other hand, many other studies conducted in the kingdom have utilized different instruments to assess knowledge.…”

“…The second section used the 26 items of the HK-LS instrument, which was developed by Erkoc et al in English to assess Turkish adults’ knowledge about hypertension and its management using 22 items that are distributed across six specific areas called subdimensions, namely: disease definition, medical treatment, drug compliance, lifestyle, diet, and complications [ 29 ]. Due to the validity and reliability of the instrument in Saudi Arabia, [ 15 ] the items were translated into Arabic. However, certain modifications were applied to the scale after consultation with experts, including an addition of one item to the disease definition subdimension, and it was added to assess participants’ knowledge regarding the increased isolated systolic pressure as a form of hypertension.…”

“…A recent study conducted in various regions of Saudi Arabia showed that the overall mean knowledge level was equivalent to 68.5% of the maximum score, and the least knowledgeable subdimensions were related to drug compliance followed by diet. In contrast, the complications and lifestyle subdimensions were optimal [ 15 ]. These previous studies investigating hypertensive patients’ knowledge levels in other Saudi regions cannot be generalized to other Saudi regions, such as the Jazan region, where a higher proportion of people suffer from hypertension and its complications and where the health system is overwhelmed by emergencies and cases of communicable and genetic diseases.…”

Assessment of Public Knowledge of Hypertension Among the Saudi Population

“…However, the lowest level of knowledge was regarding drug compliance. This finding was explained by a previous study that either due to hypertension being a silent disease, they thought to take it only when the symptoms start to appear or might be a misunderstanding of the statements, and our previous study suggested changing the statement for better understanding [ 10 ].…”

“…The Arabic version of the Hypertension Knowledge-Level Scale (HK-LS) tool was obtained from a previous study [ 9 ]. The Arabic version of the HK-LS was found to be a reliable and valid tool for measuring knowledge about hypertension among the general population [ 10 ]. The questionnaire contains two main sections.…”