| Background:Birth defects and genetic diseases seriously damage the survival and quality of life of patients,and bring heavy spiritual and economic burden to families and society.As a genetic detection technology that can reduce the risk of familial genetic diseases or chromosome abnormalities and recurrent abortion,Preimplantation genetic testing(PGT)has its irreplaceable advantages.Due to the influence of many factors,genetic counselees with PGT indications have different understanding and acceptance of PGT.Therefore,it is urgent to understand the current situation of PGT knowledge,belief and practice level and relevant influencing factors of domestic genetic counselees with PGT indications,and carry out targeted education and intervention.However,there is no research report on the research tool to evaluate the knowledge,belief and practice level of PGT among genetic counselees with PGT indications.Objective:The purpose of this study was to develop the knowledge-attitude-practice(KAP)questionnaire for the PGT among genetic counselees with PGT indications;to evaluate the reliability and validity of the KAP questionnaire for the PGT among genetic counselees with PGT indications.Methods:The item pool of the KAP questionnaire was based on the knowledge-attitude-practice model,established through literature review,qualitative interview and study group discussion.The items of the KAP questionnaire were adjusted through three rounds of expert consultation by using the Delphi method.320 genetic counselees with PGT indications were selected from the Reproductive and Genetic Hospital of CITIC-Xiangya,to investigate,screen the items of the questionnaire and evaluate the reliability and validity of the questionnaire.The item analysis adopts discrimination analysis method,correlation coefficient method,Cronbach coefficient method and factor analysis method.Validity analysis used content validity and structure validity.Reliability analysis used internal consistency,test-retest reliability and split half reliability.Results:(1)After the literature review,46 items were added in the KAP item pool,and 7 items were added through qualitative interview.Finally,the KAP item pool had 53 items,including 23 knowledge items,17 attitude items and 13 practice items.(2)In the three rounds of expert consultation,the experts’recovery rates of three rounds are more than 70%.The experts’coefficient authority of three rounds are more than 0.8.In the first round of expert consultation,28 items were deleted,17 items were added,21 items were modified and 2 items were merged.In the second round of expert consultation,one item was deleted,one item was added,23 items were modified and one item was split.In the third round of expert consultation,no item was deleted,added or modified.Finally,a revised KAP questionnaire for the PGT among genetic counselees with PGT indications was formed,including 3 dimensions and 43 items.(3)In the item analysis,the results of discrimination analysis showed that the CR of all items was>3,and the difference of t-test was statistically significant(P<0.05).The results of correlation coefficient show that the Pearson correlation coefficient r between each item and the total questionnaire is>0.3(P<0.05).The Pearson correlation coefficient r between each item and its dimension is>0.4(P<0.05).The Pearson correlation coefficient r of K9,K10,K12 and K16 in the practice dimension are>0.4(P<0.05).The Pearson correlation coefficient r of A4,A9,A13 and A14 in the practice dimension are>0.4(P<0.05).The Pearson correlation coefficient r of P2,P3,P4,P6 in the knowledge dimension are>0.4(P<0.05).The Pearson correlation coefficient r of P8 in the attitude dimension is>0.4(P<0.05).Cronbach coefficient results show that the Cronbach’sαcoefficients of each item is lower than Cronbach’s of the Cronbach’sαcoefficient of total questionnaire(0.946).The results of factor analysis showed that the factor load of all items on their corresponding common factors was>0.45 and the commonality value was>0.20.Based on the above four methods,combined with the suggestion of the research group,no item was deleted in the project analysis.(4)In the validity analysis,the I-CVI(>0.78)and the S-CVI/Ave(>0.95)confirmed the questionnaire content validity.The K*evaluation of each item is excellent.The results of structural validity showed that the KMO value of exploratory factor analysis was 0.915 and Bartlett spherical testχ~2=9903.481(P<0.05).Three factors were extracted by principal component analysis and varimax rotation.The eigenvalues were13.802,5.594 and 2.950,respectively.The contribution rates were32.098%,45.108%and 51.969%,respectively.The cumulative variance contribution rate was 51.969%.(5)In reliability analysis,the Cronbach’sαcoefficients of dimensions of knowledge,attitude and practice and the total questionnaire are 0.942,0.915,0.916 and 0.946,respectively.The split half reliability of knowledge,attitude,practice and the total questionnaire were 0.891,0.797,0.796 and 0.756,respectively.The test-retest reliability coefficient of the questionnaire was 0.779(P<0.05).Conclusion:the KAP questionnaire for the PGT among genetic counselees with PGT indications has good reliability and validity,which is composed of 3 dimensions and 43 items.The questionnaire development process is in line with the questionnaire development procedure,and the reliability and validity meet the requirements of statistical measurement.The number of items is moderate,the language is easy to understand,easy for patients to accept,and can be used in clinical research and application. |
PDF Full Text Request