Development, Validation and Application of Computer‐linked Knowledge Questionnaires in Diabetes Education

Abstract

Multiple choice questionnaires (MCQs) capable of being marked manually or by a newly developed optical mark reader, or by use of an inexpensive inter-active microcomputer system have been developed for the separate assessment of insulin-dependent and non-insulin-dependent patient knowledge. Forty-six insulin-related and non-insulin-related multiple choice questions covering six main areas of knowledge were constructed for inclusion into draft questionnaires. From the responses of a total of 180 completed questionnaires, piloted in 18 randomly selected clinics in 14 Regional Health Authorities in England, psychometric analysis was performed to determine reliability, discrimination coefficients, and facility indices. Seventy-three per cent of insulin-dependent diabetic patients (IDDM) and 92% of non-insulin-dependent diabetic patients (NIDDM) MCQ correct options had facility indices within the acceptable range of 30 to 90%. 82% IDDM and 93% NIDDM correct options had discrimination coefficients exceeding 0.2. Questionnaire reliability (internal consistency) using the Kudor-Richardson (KR20) formula was IDDM 0.87 and NIDDM 0.82. Evidence in support of the IDDM questionnaire's criterion validity was based on significant differences (p less than 0.05) identified between a number of knowledge area scores stratified according to HbA1 levels. Prescriptive correction for screen display and automatic hard copy feedback was designed for both incorrect and omitted question options, providing both educational (patient) and analytical (clinic) documentation. Both technical and psychometric properties of these knowledge assessment instruments should be acceptable for diabetic knowledge evaluation and instruction.

A Trial of Cognitive Analytic Therapy in Poorly Controlled Type I Patients

“…Mean diabetes knowledge scores at the start of treatment were 58.2 ± 15.5% for CAT patients and 60.9 ± 12.0% for DSNE patients, which are similar to the scores from the "good control" patients in the Charing Cross study (11). Table 3 shows that diabetes knowledge increased significantly at all retest points in the CAT group (P = 0.04, <0.05, <0.05, respectively) and at the 9-month point after DSNE (P = 0.003).…”

“…Diabetes knowledge. The Charing Cross Diabetes Knowledge Questionnaire was used to measure diabetes knowledge (11). This is a 46-item validated self-completion questionnaire covering six main areas of diabetes knowledge from diet to insulin administration and foot care.…”

Improving foot care for people with diabetes mellitus – a randomized controlled trial of an integrated care approach

“…A multiple choice questionnaire, evaluating patients' knowledge, and attitudes to, diabetic footcare was completed by patients immediately prior to and on completion of the 6 month intervention period. The questionnaire, modelled closely on previously validated work[14], was developed and verified locally in terms of face validity, test–re‐test reliability (Pearson's correlation coefficient of 0.65 ( P < 0.001) for knowledge scores and 0.55 ( P < 0.001) for attitude scores) and internal consistency (Cronbach's alpha of 0.74 for knowledge scores and 0.76 for attitude scores) in a diabetic population sample ( n = 40) drawn from outside the study area. The questionnaire was distributed amongst general practitioners, practice nurses, district nurses and chiropodists in both intervention and control groups, before and after the intervention period.…”

The use of degrees of certainty to evaluate knowledge

“…The most frequently adopted method for analysing the effect of education on knowledge takes advantage of questionnaires where the right answers are chosen from multiple choices or between just two possibilities (true/false questions) [7][8][9][10]. These tests are easy to apply, score objectively and interpret.…”