Cross-culture adaptation and validation of English version of Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS) in patients with rheumatoid arthritis

Int J Rheum Dis. 2020 Jul;23(7):918-927. doi: 10.1111/1756-185X.13860. Epub 2020 Jun 11.

Abstract

Aim: To carry out cross-culture adaptation and validation of the English version of Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS) in patients with rheumatoid arthritis (RA).

Methods: A cross-sectional study was conducted for 2 months in 2 tertiary care hospitals in Karachi, Pakistan. Sample size was calculated based on item-subject ratio. The translation was carried out using standard procedures for translation and cross-culture adaptation. The validation process included estimation of discrimination power, item difficulty index, factorial, convergent, construct and known group validities and reliability. Reliability of the scale was estimated using Kuder-Richardson Formula 20 and a value of σ2 ≥ 0.6 was acceptable. SPSS v23, Remark Classic OMR v6 software and MedCalc Statistical Software v16.4.3, were used to analyze the data. The study was approved by the relevant ethics committee (IRB#NOV:15).

Results: The mean score was 7.68 ± 2.52 (95% CI: 7.31-8.05) for 177 patients. The σ2 = 0.601, that is, >0.6, test-retest reliability ρ = .753, P < .05. The average discrimination power = 47.27, average Item Difficulty Index = 0.557. The fit indices were acceptable in a range that established its factorial validity and average factor loading was ≥0.7 which established convergent validity. A significant association (χ2 = 33.074, P < .01) between score interpretation and previous counseling by pharmacists established its construct validity. A significant association (χ2 = 19.113, P < .05) between score interpretation and patient occupation established known group validity.

Conclusion: The English version of RAKAS was deemed a reliable and validated tool to measure knowledge about disease in Pakistani patients with RA.

Keywords: arthritis; disease knowledge; patient knowledge; rheumatoid; validation.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / ethnology
  • Arthritis, Rheumatoid* / physiopathology
  • Arthritis, Rheumatoid* / therapy
  • Cross-Sectional Studies
  • Cultural Characteristics*
  • Female
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Health Literacy*
  • Humans
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Psychometrics
  • Reproducibility of Results
  • Risk Factors
  • Surveys and Questionnaires*
  • Translating*