Content validation of a structured questionnaire to assess the knowledge, attitudes, and practices of respiratory therapists regarding education for COPD self-management.

Abstract

Introduction: Self-management education is a fundamental pillar in the non-pharmacological management of chronic obstructive pulmonary disease (COPD), and respiratory therapists (RTs) play a central role in this process. In Colombia, the heterogeneity of training programs may lead to differences in the knowledge, attitudes, and practices (KAP) of RTs. In this context, the present study aimed to validate the content of an instrument designed to assess RTs' KAP regarding self-management education.

Methods: The instrument, consisting of 25 items distributed across three components (knowledge, attitudes, and practices), was developed by an interdisciplinary team and evaluated by experts in respiratory therapy with experience in COPD and teaching. The evaluation was conducted using an online questionnaire that assessed the dimensions of Relevance, Clarity, Coherence, and Vocabulary on a 0-to-5 Likert scale. To complement the analysis, the I-CVI, S-CVI/Ave, and Aiken's V coefficient were calculated.

Results: Ten of the twelve invited experts completed the evaluation (83.3%). All had training in respiratory therapy and extensive clinical and teaching experience in the management of patients with COPD (n = 10, 100%). Ninety-six percent of the items obtained an I-CVI ≥ 0.78, with Aiken's V values ranging from 0.84 to 1.00. At the scale level, the S-CVI/Ave was 0.96 for Relevance, 0.88 for Clarity and Coherence, and 0.98 for Vocabulary, with a global S-CVI/Ave of 0.94. The lowest scores were observed in the Clarity and Coherence dimension of the Knowledge component (items Q1, Q3, and Q8).

Discussion: The results showed that the instrument has high content validity for assessing the KAP of RTs regarding self-management education for COPD. Although some items in the Knowledge component within the Clarity and Coherence dimension had an I-CVI < 0.78, Aiken's V values indicated a positive evaluation by the experts, which justified not making any modifications. The differences observed in the Clarity and Coherence dimension are consistent with previous findings regarding the complexity of technical knowledge items. This instrument can guide the implementation of educational strategies, professional training, and future psychometric studies, such as construct validity and reliability assessments.

Conclusion: The designed instrument demonstrated excellent content validity in Relevance and Vocabulary components and good validity in the Clarity and Coherence component, with items that were relevant, clear, coherent, and used appropriate vocabulary, as supported by I-CVI, S-CVI/Ave, and Aiken's V.