# Validation of the orthostatic hypotension knowledge, attitudes, and practices questionnaire and investigation of influencing factors: a cross-sectional study

## TL;DR

This study developed and validated a questionnaire to assess hospitalized patients' knowledge, attitudes, and practices regarding orthostatic hypotension and identified factors influencing their scores.

## Contribution

The study introduces a validated questionnaire for assessing OH-related knowledge and identifies key factors influencing patient scores.

## Key findings

- The KAPQ demonstrated high reliability with a Cronbach’s alpha of 0.97 and strong test–retest reliability.
- Higher education and health education on OH were associated with lower risks of low KAPQ scores.
- A higher FES-I score was linked to a decreased risk of low KAPQ scores.

## Abstract

This study aimed to develop and validate tools to assess inpatients’ knowledge, attitudes, and practices concerning orthostatic hypotension (OH) and to explore the influencing factors.

This study was a cross-sectional validation study conducted from July to December 2024.

This research employed a cross-sectional study design, in which the OH knowledge, attitudes, and practices questionnaire (KAPQ) was administered to hospitalized patients. The Delphi expert consultation, Spearman correlation analysis and factor analysis were used to evaluate and validate the questionnaire. The current status and influencing factors of patients’ KAPQ scores were subsequently analyzed.

Of the 1,488 patients who completed the validated questionnaire, 12.77% experienced OH in the hospital. The KAPQ had a Cronbach’s alpha of 0.97, with exploratory factor analysis revealing three factors explaining 74% of its variance. The item-total correlations for the KAPQ ranged from 0.55 to 0.82. Test–retest reliability was evaluated with a Spearman rank correlation coefficient of 0.89. Individuals with a college education or higher had a lower risk of low KAPQ scores than did those with a high school education or less (OR: 0.67, 95% CI: 0.55–0.82). Receiving health education on OH also reduced the risk of low scores (OR: 0.36, 95% CI: 0.30–0.45). Additionally, a higher FES-I score was linked to a decreased risk of low KAPQ scores (OR: 0.98, 95% CI: 0.97–0.99).

The self-reported KAPQ scale demonstrated robust reliability and validity coefficients, effectively assessing knowledge, attitudes, and practices regarding OH among inpatients. Inpatients who had received health education related to OH, had higher FES-I scores, possessed higher educational levels, and achieved comparatively elevated KAPQ scores concerning OH.