Validation of a questionnaire for the assessment of knowledge, attitude, and practices in patients with irritable bowel syndrome
Keywords:Attitude, Inflammatory bowel syndrome, KAP questionnaire, Knowledge, Practices, Validation
Background: Irritable bowel syndrome (IBS) is a common disorder with a significant impact on the patients’ quality of life. The objective if this study was to develop and validate knowledge, attitude, and practices (KAP) questionnaire in patients with IBS.
Methods: The questionnaire was developed by medical experts by a consultative process using available literature on KAP for patients with IBS. Contents of the questionnaire were validated based on content clarity and relevance using a 4-point ordinal scale. A cross-sectional survey of 100 individuals with IBS was carried out to establish internal consistency, followed by the establishment of the construct validity of the questionnaire.
Results: The original KAP questionnaire included 32 items categorized under the 3 domains of knowledge (22 items), attitude (6 items), and practices (8 items). During expert validation, 4 items from knowledge domain and 1 item from attitude domain were revised. For the original questionnaire, for the individual KAP domains and the overall questionnaire, the Cronbach's alpha raw values were 0.384, 0.215, 0.548, and ‑0.028, and standardized values were 0.395, 0.368, 0.490, and 0.119, respectively. Six items from knowledge domain and 1 item from attitude domain were deleted to strengthen the internal consistency without jeopardizing the purpose of study. For the questionnaire with 29 items, Cronbach's alpha values improved to 0.603, 0.314, 0.548, and 0.483 (raw values) and 0.586, 0.350, 0.490, and 0.414 (standardized values), respectively.
Conclusions: The validated questionnaire with 29 items had improved homogeneity as compared with the initial questionnaire with 36 items.
World Gastroenterology Organisation Global Guidelines. Irritable bowel syndrome: a global perspective. Available at: http://www.worldgastroenterology.org/guidelines/global-guidelines/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs-english. Accessed on: 17 Dec 2018.
Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, et al. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult. Rev Esp Enferm Dig. 2016;108(6):332-63.
Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:712-21.
Makharia GK, Verma AK, Amarchand R, Goswami A, Singh P, Agnihotri A, et al. Prevalence of irritable bowel syndrome: a community based study from northern India. J Neurogastroenterol Motil. 2011;17:82-7.
Ghoshal UC, Abraham P, Bhatt C, Choudhuri G, Bhatia SJ, Shenoy KT, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian society of gastroenterology task force. Indian J Gastroenterol. 2008;27:22-8.
Upadhyay R, Singh A. Irritable bowel syndrome: The Indian scenario. Available at: http://www.apiindia.org/medicine_update_2013/chap56.pdf . Accessed on 17 December 2018.
O'Sullivan MA, Mahmud N, Kelleher DP, Lovett E, O'Morain CA. Patient knowledge and educational needs in irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2000;12:39-43.
Lacy BE, Weiser K, Noddin L, Robertson DJ, Crowell MD, Parratt‐Engstrom C, et al. Irritable bowel syndrome: patients' attitudes, concerns and level of knowledge. Aliment Pharmacol Ther. 2007;25:1329-41.
Harris LR, Roberts L. Treatments for irritable bowel syndrome: patients' attitudes and acceptability. BMC Complement Altern Med. 2008;8:65.
The KAP survey model (knowledge, attitudes, and practices). Available at: https://www.spring-nutrition.org/publications/tool-summaries/kap-survey-model-knowledge-attitudes-and-practices. Accessed on 17 Dec 2018.
Gwee KA, Bak YT, Ghoshal UC, Gonlachanvit S, Lee OY, Fock KM, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1189-205.
Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53-5.
Algabr GA, Alotaibi TK, Alshaikh AM, Maimani YT, AlShehri MS. Assessment of knowledge, attitude and practice towards irritable bowel syndrome and risk factors in Riyadh city, 2017. Egypt J Hosp Med. 2018;70:1377-80.