title: A comprehensive approach to psychometric assessment of instruments used in dementia educational interventions for health professionals: a cross-sectional study.
abstract: BACKGROUND
  Suboptimal care for people with dementia in hospital settings has been reported and is attributed to the lack of knowledge and inadequate attitudes in dementia care among health professionals. Educational interventions have been widely used to improve care outcomes; however, Chinese-language instruments used in dementia educational interventions for health professionals are lacking.
  
  
  OBJECTIVE
  The aims of this study were to select, translate and evaluate instruments used in dementia educational interventions for Chinese health professionals in acute-care hospitals.
  
  
  METHODS
  A cross-sectional study design was used.
  
  
  METHODS
  A modified stratified random sampling was used to recruit 442 participants from different levels of hospitals in Changsha, China.
  
  
  METHODS
  Dementia care competence was used as a framework for the selection and evaluation of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale for health professionals in the study. These two scales were translated into Chinese using forward and back translation method. Content validity, test-retest reliability and internal consistency were assessed. Construct validity was tested using exploratory factor analysis. Known-group validity was established by comparing scores of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale in two sub-groups. A person-centred care scale was utilised as a gold standard to establish concurrent validity of these two scales.
  
  
  RESULTS
  Results demonstrated acceptable content validity, internal consistency, test-retest reliability and concurrent validity. Exploratory factor analysis presented a single-factor structure of the Chinese Alzheimer's Disease Knowledge Scale and a two-factor structure of the Chinese Dementia Care Attitudes Scale, supporting the conceptual dimensions of the original scales. The Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale demonstrated known-group validity evidenced by significantly higher scores identified from the sub-group with a longer work experience compared to those in the sub-group with less work experience.
  
  
  CONCLUSIONS
  The use of dementia care competence as a framework to inform the selection and evaluation of instruments used in dementia educational interventions for health professionals has wide applicability in other areas. The results support that Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale are reliable and valid instruments for health professionals to use in acute-care settings.
authors.affiliation: Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia. Electronic address: lily.xiao@flinders.edu.au.
authors.forename: Lily Dongxia
authors.initials: LD
authors.lastname: Xiao
authors.affiliation: Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China. Electronic address: hgpcsu512@163.com.
authors.forename: Guo-Ping
authors.initials: GP
authors.lastname: He
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000451:nursing; D044466:Asian People; D002681:China; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006281:Health Occupations / Q000193:education*; D006801:Humans; D008297:Male; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014175:Translating
keywords: Dementia care competence; Dementia educational interventions; Health professionals; Instrument validation; Translation