The development and psychometric testing of a knowledge tool on incontinence-associated dermatitis for clinicians (KnowIAD)

Michelle Barakat-Johnson, Dimitri Beeckman, Jill Campbell, Ann Marie Dunk, Michelle Lai, John Stephenson, Fiona Coyer

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The purpose of this study is to describe the development and evaluation of the psychometric properties of a tool used to assess clinician knowledge of incontinence-associated dermatitis.
Design: The instrument was developed in three phases: Phase 1 involved item development; Phase 2 evaluated content validity of the instrument by surveying clinicians and lay stakeholders within a single state of Australia and, Phase 3 used a pilot multisite cross-sectional survey design to determine composite reliability and evaluate scores of the knowledge tool.
Subjects and Setting: In Phase 1, the instrument was developed by five persons with clinical and research subject expertise. In Phase 2, content validity was evaluated by a group of 13 clinicians (nurses, physicians, occupational therapists, dietitians, and physiotherapists) working in acute care across one Australian state, New South Wales, and two consumer representatives. In Phase 3, clinicians, working across five health districts in New South Wales and in hospitals and on wards with patients who were diagnosed with incontinence-associated dermatitis, participated in pilot- testing the instrument.
Methods: During Phase 1, a group of local and international experts developed a preliminary tool based on an international consensus document, our prior research evaluating incontinence-associated dermatitis knowledge, and consensus among expert panel of clinicians and researchers. Phase 2 used a survey design to determine content validity of the knowledge tool. Specifically, we calculated item- and scale-level content validity ratios and content validity indices for all questions within the draft instrument. Phase 3 comprised pilot-testing of the knowledge tool using a cross-sectional survey. Analysis involved confirmatory factor analysis to confirm the hypothesized model structure of the knowledge tool, as measured by model goodness-of-fit. Composite reliability testing was undertaken to determine the extent of internal consistency between constituent items of each construct.
Results: Phase 1 developed the Barakat-Johnson Incontinence-Associated Dermatitis Knowledge tool (Know-IAD), comprising 19 items and divided into three domains of IAD-related knowledge: 1) Etiology and Risk, 2) Classification and Diagnosis, and 3) Prevention and Management. In Phase 2, 18 of the 19 items demonstrated high scale content validity ratios scores on relevance (0.75) and clarity (0.82); and high scale-content validity indices scores on relevance (0.87) and clarity (0.91). In Phase 3, 204 respondents completed the survey and the Know-IAD tool. The final 18-item Know-IAD tool demonstrated construct validity by model goodness-of-fit, as measured by the root mean square error of approximation (RMSEA), which was excellent for the Etiology and Risk domain (RMSEA=0.02) and Prevention and Management domains (RMSEA=0.02); and good in the Classification and Diagnosis domain (RMSEA=0.04). Composite reliability (CR) was good in the Etiology and Risk domain (CR=0.76) and Prevention and Management domains (CR=0.75) and adequate in the Classification and Diagnosis domain (CR=0.64). Respondents had good understanding of etiology and risk (72.6% correct responses); fairly good understanding of prevention and management of IAD (64.0% correct responses) and moderate understanding of classification and diagnosis (40.2% correct responses).
CONCLUSION: The Know-IAD demonstrated good psychometric properties and provides preliminary evidence that it can be applied to evaluate clinician knowledge of incontinence-associated dermatitis.
Original languageEnglish
JournalJournal of Wound, Ostomy and Continence Nursing
Publication statusAccepted/In press - 19 Oct 2021

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