Health literacy scale for women with polycystic ovary syndrome (HL-PCO): Instrument development and cross-sectional validation study

Abstract

Background

Health literacy is crucial in shaping health outcomes for individuals with polycystic ovary syndrome (PCOS), influencing their disease perceptions, treatment adherence, and self-management behaviors. Women with PCOS often face challenges due to inadequate health literacy, leading to delayed diagnosis and low treatment compliance. However, there is a lack of specific tools to measure health literacy within the context of PCOS, hindering accurate assessments and targeted interventions.

Method

To address this gap, a health literacy scale for women with PCOS (HL-PCO) was developed and validated. The initial items were generated through a comprehensive literature review, in-depth interviews, and the Delphi method. A cross-sectional validation study was conducted at a tertiary hospital in Changsha, China, using classical test theory (CTT) and item response theory (IRT) for item selection. Reliability was assessed using Cronbach's α coefficient and split-half reliability, while validity was evaluated through various analyses.

Result

The HL-PCO scale retained 17 items across four factors: Acquisition, Understanding, Appraisal, and Application. Confirmatory factor analysis exhibited acceptable goodness-of-fit indices, and the Item Content Validity Index values surpassed 0.833. Robust results were also demonstrated through analyses of convergent validity, discriminant validity, and concurrent validity. The Cronbach's α coefficient for the HL-PCO was 0.930, and the split-half reliability coefficient amounted to 0.836.

Conclusion

The refined HL-PCO scale, comprising 17 items across four factors, has been rigorously validated as a reliable instrument. Its implementation has the potential to enhance health literacy assessment and improvement among women with PCOS, facilitating more effective health education interventions and ultimately improving patient outcomes.