The Chinese Version Of Diabetic Retinopathy Knowledge And Attitude Scale And Its Preliminary Application

Objective1.To give medical personnel an instrument for evaluating diabetic retinopathy,the Diabetic Retinopathy Knowledge and Attitude(DRKA)scale was created.(Dr).Knowledge and mindset regarding DR were evaluated.2.To examine the knowledge and attitudes of diabetic retinopathy patients in China using the Chinese translation of the DRKA scale,as well as the variables that influence patients’ knowledge and attitudes,in order to develop a theoretical framework for future interventional study.Methods1.Chinesization of the scale and evaluation of its psychometric properties: Professor Eva was contacted by email to obtain the official permission of the Chinese version of the DRKA scale..Using the translation stages of the modified Brislin translation model,the content of the scale was correctly translated,acceptable modifications were made,and suitable performance assessment was carried out to produce the Chinese version of the DRKA.Convenience sampling was used to pick patients diagnosed with diabetes mellitus and diabetic retinopathy in the ophthalmology clinic and ward of a Class III Grade A hospital in Hohhot,Inner Mongolia Autonomous Region,from December 2021 to August 2022.The questionnaire survey was conducted using the patient data questionnaire,the Chinese version of the DRKA questionnaire,the Diabetic Retinopathy Knowledge,Attitude,and Behavior questionnaire(only the corresponding knowledge and attitude part was used),and the survey results were used to evaluate the measurement characteristics of the DRKA scale.Winsteps3.66.0 software was used to evaluate the Rasch Model.The knowledge scale was scored using the standard Rasch model(dichotomous scoring),and the attitude scale was scored using the Partial Credit Model(PCM)(Likert 4 scoring).The assessment scale,single dimension,fitting statistics,reliability,discrimination,difficulty and ability distribution,and item function differences were used to analyze the test results.To analyze Cronbach’s a coefficient,known population validity,and verify the correlation between DRKA scale and criterion,SPSS 26.0 software was used.2.Status survey: Convenience sampling was used to select patients diagnosed with diabetes mellitus and diabetic retinopathy in the ophthalmology clinic and ward of a Class III Grade A hospital in Hohhot,Inner Mongolia Autonomous Region,and Changzhi,Shanxi Province,from September 2022 to January 2023.The patient information questionnaire,Chinese version of the DRKA measure,Diabetic retinopathy related behavior Questionnaire,Social Support Rating measure,and self-efficacy Scale were used to assess the patients.The present status of knowledge and attitude of DR Patients,as well as the related influencing factors of knowledge and attitude of DR Patients,were analyzed based on the survey findings.If the measurement data had a normal distribution and homogeneity of variance,it was written as(mean standard deviation).Data from non-normal distributions were represented as median and quartile.The frequency and percentage of count data were explained.The data were entered into the SPSS 26.0 program for analysis,and the differences in general patient data were analyzed using the independent sample t test or one-way analysis of variance.The link between DRKA and DR-related behaviors,social support,and self-efficacy was investigated using Pearson correlation analysis.The statistically significant factors were chosen as independent variables and the knowledge and attitude ratings were used as dependent variables for multiple linear stepwise regression analysis in accordance with the findings of univariate analysis and correlation analysis.Results1.The Chinese version of DRKA worked well with the Rasch model.The knowledge and attitude scales were unidimensional,with no item mismatch or group dependence.However,the threshold number between the options of the attitude scale was too small.The knowledge scale has good Item Reliability(IR),Person Reliability(PR),Person Separation Index(PSI),and Item Separation Index(ISI),indicating that the results obtained by the knowledge scale are reliable,and at least three difficulty levels can distinguish DR Patients into three ability levels;the attitude scale has good PR,IR,and ISI,but the PSI value is slightly lower,indicating that reliable results can be obtained through the attitude scale,and Cronbach’s a for the knowledge and attitude scales were 0.845 and 0.822,respectively,showing that the DRKA was reliable.The Pearson correlation coefficients between the knowledge and attitude scale and the diabetic retinopathy Knowledge,attitude,and Behavior questionnaire(corresponding part)were 0.842(P<0.001)and 0.814(P<0.001),respectively,showing that the DRKA had good convergent validity.The knowledge and attitude scale scores increased with education,suggesting acceptable known-group validity of the DRKA.2.Status survey: Patients with diabetic retinopathy have poor mastery of disease-related knowledge.Univariate analysis revealed that gender,age,education level,average monthly family income,duration of diabetes,visual impairment,willingness to participate in disease knowledge lectures or training,and difficulty obtaining disease-related information were all statistically significant(P<0.05).The disease-related views of diabetic retinopathy patients are moderate.Univariate analysis revealed that gender,age,occupation,education level,average monthly family income,duration of diabetes,whether there was visual impairment,blood glucose control,whether to participate in disease knowledge lectures or training,and whether it was difficult to obtain disease-related information were statistically significant(P<0.05)The total score of social support of patients with diabetic retinopathy was positively correlated with the score of DR-related knowledge(r=0.896,P<0.001),attitude(r=0.920,P<0.001),practice(r=0.737,P<0.001).The self-efficacy of patients with diabetic retinopathy was positively correlated with DR-related knowledge(r=0.885,P<0.001),attitude(r=0.894,P<0.001)and practice(r=0.695,P<0.001).Multiple linear stepwise regression analysis revealed that self-efficacy,objective support,subjective support,social support utilization,and whether to participate in disease knowledge lectures or training entered the regression equation(P<0.001),explaining 83.0% of the total variation in disease-related knowledge level in DR patients.Multiple linear stepwise regression analysis revealed that self-efficacy,objective support,subjective support,social support utilization,blood glucose control,and whether to participate in disease knowledge lectures or training entered the regression equation(P<0.001),explaining 87.0% of the total variation of disease-related attitudes in DR patients.Conclusion1.Despite the fact that the Chinese version of the DRKA has a tiny threshold between attitude scale choices and a slightly lower individual separation index,it can still assess the disease-related information and attitude of DR patients in a scientific and reasonable manner.2.The level of disease-related knowledge in patients with diabetic retinopathy was closely related to self-efficacy,objective support,subjective support,social support utilization and whether to participate in disease knowledge lectures or training.The level of disease-related attitudes in patients with diabetic retinopathy is closely related to self-efficacy,objective support,subjective support,social support utilization,blood glucose control,and whether to participate in disease knowledge lectures or training.Getting better social support and enhancing patients’ self-efficacy can help to improve patients’ knowledge,attitude and behavior,and then delay the progression of the disease.During clinical nursing,it is necessary to formulate more detailed nursing intervention measures according to the above influencing factors,help patients to obtain available social support resources and enhance patients’ self-efficacy to ensure that patients get the maximum nursing benefits.