Psychometric properties and validation of the revised Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP-R)

Abstract

BackgroundMedication literacy is one of the key indicators that can affect the self-management of medications and medication safety. This study aimed to revise the Chinese Medication Literacy Scale for hypertensive patients (C-MLSHP) and test the reliability and validity of the revised scale.MethodsWe revised the C-MLSHP by several methods, i.e., focus group discussion, expert consultation, patient interview, and pilot study, based on the established evaluation index system of medication literacy for hypertensive patients. Then, a formal survey using the revised Chinese Medication Literacy Scale for hypertensive patients (C-MLSHP-R) was carried out on hypertensive patients from hospitals and community healthcare centers in Changsha city of China to test its reliability and validity. The reliability was evaluated with Cronbach's α coefficient, split-half reliability, and test–retest reliability. The validity was evaluated with content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity.ResultsThe C-MLSHP-R contained 18 items within four domains, i.e., the knowledge domain included four items, the attitude domain had three items, the skill domain involved seven items, and the practice domain included four items. A total of 339 hypertensive patients participated in the formal survey. The results showed that the Cronbach's α coefficient of C-MLSHP-R was 0.802, and for each domain ranged from 0.639 to 0.815. The split-half reliability coefficient of C-MLSHP-R was 0.709, and for each domain ranged from 0.648 to 0.792. The test–retest reliability coefficient of C-MLSHP-R was 0.851, and for each domain ranged from 0.655 to 0.857. The I-CVI of each item ranged from 0.833 to 1.000, the S-CVI/Ave of C-MLSHP-R was 0.981, the S-CVI/UA was 0.889, and for each domain ranged from 0.958 to 1.000. Confirmatory factor analysis results showed that the model fitted well. The convergent validity of C-MLSHP-R was acceptable, and the discriminant validity was good. The criterion coefficient between C-MLSHP-R and C-MLSHP was 0.797, and for each domain ranged from 0.609 to 0.755.ConclusionCompared with C-MLSHP, the C-MLSHP-R with 18 items was much shorter for measuring, and had decreased reliability within the acceptable range and better validity, which was more appropriate and time-saving to assess the medication literacy level for hypertensive patients scientifically and conveniently.

The Role of Medication Literacy in the Treatment of Hypertensive Patients: A Review

“…Ma also reported on four factors influencing the level of medication literacy, i.e., educational, social, economic, and insurance type factors (Ma et al, 2020). (Qin et al, 2023). The lowest scores were observed in the medication knowledge dimension, with the other dimensions-medication skills, medication practice, and patient attitude-following the standardized score range of 0.61±0.33 -0.66±0.26.…”

“…Of these, 18 articles were excluded because they (1) involved interventions (n=4), (2) focused on health literacy unrelated to medication use (n=8), (3) were conducted in the same location (n=2), and (4) had irrelevant topics (n=4). Two articles reported by Ma et al (2020) and Qin et al (2023) met the criteria for further review of the article review process (Ma et al, 2020;Qin et al, 2023). Both studies, conducted in China by Ma et al and Qin et al, gathered data from different research areas and years (Table I).…”

“…These two studies employed a cross-sectional design, with over 50% male respondents and an average age above 60 years. Medication literacy in both studies was measured using the Chinese version of the Medication Literacy Scale for Hypertensive Patients (C-MLSHP) (Ma et al, 2020) and revised version of C-MLSHP (C-MLSHP R) (Qin et al, 2023). C-MLSHP R explored the knowledge dimension of medication in more depth and detail than C-MLSHP.…”

“…C-MLSHP R explored the knowledge dimension of medication in more depth and detail than C-MLSHP. Furthermore, medication practice literacy in C-MLSHP R focused more on overall patient behaviors related to seeking information about medication, making medication-related decisions, adherence to treatment schedules, as well as self-monitoring and supervision (Ma et al, 2020;Qin et al, 2023).…”

Association between medication literacy and blood pressure control among hypertensive patients

“…This study used the Revised Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP-R), revised from the Chinese Medication Literacy Scale for Hypertensive Patients, which has been subjected to rigorous expert consultation and evaluation of reliability and validity (Qin et al, 2022). The C-MLSHP-R has 18 items in four dimensions: four multiple-choice items on knowledge dimension with 1 point for a correct choice, three items on attitudes and four items on practice with 0-4 points on a Likert five-point scale with items A1 to A3 reverse scored, seven items on medication skills with 1 point for a correct answer, 0 points for a wrong answer or do not know.…”