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Anteayer Journal of Advanced Nursing

Development and Psychometric Evaluation of KAP‐ST: A Knowledge, Attitude and Practice Instrument for Care Workers at Preventing Skin Tears

ABSTRACT

Aim

Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults.

Method

The KAP-ST was developed and validated in four phases during May–October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities.

Result

The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test–retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684).

Conclusion

The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity.

Implications for the Profession

STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers.

Reporting Method

Standardised Guidelines for Scale Construction and COSMIN checklist.

Patient or Public Contribution

No patient or public contributions.

‘Living Well With a PICC at Home’: Co‐Design and Evaluation of a Peripherally Inserted Central Catheter (PICC) Booklet

ABSTRACT

Aim

To co-design an information booklet to support adults living with a peripherally inserted central catheter (PICC) at home.

Design

A sequential, mixed-method approach using Boyd's co-design framework.

Method

A diverse project team led co-design of a PICC booklet based on preferences and PICC management strategies identified through content analysis of interviews with 15 Australian health consumers (January 2022–March 2023) using a qualitative descriptive approach. A draft booklet was developed, reviewed by the team and prototyped, which was evaluated by consumer participants and an external nurse panel, with readability assessed using Flesch Reading Ease and Flesch–Kincaid scores. The project team reviewed feedback, reached consensus on changes and collaborated with designers to produce the final booklet.

Results

Consumer participant strategies were classified into four categories: enhancing coping, taking responsibility and understanding information, modifying life and accessing supports. Two pre-determined categories were included (participant recommendations for PICC education resource content and top tips for living with a PICC). The prototype was evaluated as highly relevant (3.9/4), comprehensive (3.8/4) with an appropriate writing style and visual appeal. Readability scores were 76.1/100 (Flesch Reading Ease) and 6.9 (Flesch–Kincaid grade level). The final booklet contained 13 sections.

Conclusion

A co-design approach successfully created a novel PICC information booklet with positive evaluations.

Implications

Provides understanding of consumer information preferences to inform PICC education and offers insight into consumer-developed strategies and knowledge for living with a PICC.

Impact

A co-designed PICC information booklet based on consumer knowledge may augment nursing education for people living with a PICC to improve outcomes.

Reporting Method

The qualitative component follows the EQUATOR network COREQ guideline. A co-design research reporting standard is not available.

Patient or Public Contribution

A consumer representative was a member of the project team and contributed to study design, interpretation of findings and development of the booklet and manuscript.

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