Design and validation of nurses’ knowledge, attitude and practice questionnaire for discharge planning of stroke patients

TL;DR

This study created and validated a questionnaire to assess nurses' knowledge, attitude, and practice in discharge planning for stroke patients, finding it reliable and valid for clinical use.

Contribution

A culturally appropriate, validated questionnaire for assessing nurses' KAP in stroke patient discharge planning was developed and tested.

Findings

The questionnaire had high reliability (Cronbach’s alpha 0.909, retest 0.924) and validity (content validity index 0.972).

Nurses' knowledge and practice scores were below the threshold of 85, indicating areas needing improvement.

Factor analysis confirmed the questionnaire's structural validity with a KMO value of 0.966.

Abstract

The aim of this study was to design a national and culturally appropriate questionnaire to assess the nurses’ knowledge, attitude and practice (KAP) for discharge planning of stroke patients and to test the reliability and validity of this questionnaire.

This questionnaire was developed using domestic and international literature and combining the KAP theory. It covered eight aspects of basic knowledge, relevant knowledge, psychological cognition, emotional tendency, intentional behavior, assessment, implementation and evaluation of discharge planning for stroke patients. The item pool was established through Delphi expert inquiry to form a pre-survey questionnaire. The pre-survey was first administered to 60 clinical nurses, then tested on 626 clinical nurses. Finally the questionnaire’s reliability was assessed through retest reliability, split-half reliability, and Cronbach’s α coefficient, while the validity of the scale was evaluated through content validity, structural validity, and factor analysis.

The final formal questionnaire was used to assess nurses’ KAP for discharge planning of stroke patients. The questionnaire consisted of 37 items in three dimensions: knowledge (12 items), attitude (10 items) and practice (15 items). The questionnaire had an average expert authority coefficient of 0.88, a consistency coefficient of 0.454, a total internal consistency reliability (Cronbach’s alpha coefficient) of 0.909, a retest reliability of 0.924, and a content validity index of 0.972. The results of this study were calculated on a dimensional basis, resulting in the following standard scores: 84.01 (<85) for the knowledge dimension, 90.61 (>85) for the attitude dimension, and 81.83 (<85) for the practice dimension. The correlation coefficients between the three dimensions and the total questionnaire were 0.635, 0.659, and 0.566, respectively. The Kaiser-Meyer-Olkin (KMO) value was 0.966, and the sphere test value was p < 0.0001.

The questionnaire on nurses’ KAP for discharge planning of stroke patients showed good reliability and validity. It is suitable for use by clinical nurses. Nurses in Level-3 hospitals across the country need to improve their knowledge, attitude and practice regarding discharge planning for stroke patients.