Development and Validation of the Kidney Transplant Understanding Tool (K-TUT)

Abstract

BackgroundSeveral educational interventions have been designed to improve patient knowledge before and after kidney transplantation. However, evaluation of such interventions has been difficult because validated instruments to measure knowledge-based outcomes in this population have not been developed.ObjectiveTo create a tool to measure patient knowledge of kidney transplantation and to evaluate its validity.MethodsThe Kidney Transplant Understanding Tool (K-TUT) was created using a stepwise iterative process. Experts in the field and transplant recipients were consulted to establish content validity. The K-TUT consists of 9 true/false and 13 multiple-choice questions, and scores are based on the number correct answers [YES/NO format] of 69 items. The questionnaire was piloted in a study that also measured health literacy (via the Short Test of Functional Health Literacy) in transplant candidates, whereas the main survey was mailed to transplant recipients. Test-retest was performed, and completed surveys were analyzed for internal consistency, construct validity, floor and ceiling effects, and reproducibility.ResultsSurveys were offered to 106 pretransplant patients and 235 in the posttransplant period, and response rates were 38.7% (41/106) and 63.4% (149/235), respectively. The mean corrected scores were 53.1 ± 8.5 (77%) and 56.2 ± 6.3 (81%), respectively. Test-retest was performed over 20% of both cohorts and percent agreement ranged between 70% and 100% in the pretransplant group and 66% and 100% in the posttransplant group. Cronbach α ranged from 0.794 to 0.875 in all cohorts indicating favorable internal consistency. Increased health literacy in the pretransplant group was significantly associated with increased knowledge (r = 0.52; P < 0.001), suggestive of construct validity, and the absence of floor and ceiling effects was positive. The majority of transplant recipients (98/148, 67%) believed the questionnaire adequately assessed transplant knowledge, about a quarter (36/148, 24.3%) were “unsure,” and 85% (126/148) agreed that no questions should be removed.ConclusionsAlthough more study is warranted to further assess psychometric properties, the K-TUT appears to be a promising tool to measure transplant knowledge.

Randomised controlled trial of a video intervention and behaviour contract to improve medication adherence after renal transplantation: the VECTOR study protocol

“…Similar to previous research in transplantation, health literacy will be assessed with two items scored on Likert-type scales: ‘How often do you have someone (like a family member, friend, hospital/clinic worker or caregiver) help you read hospital materials?’, and ‘How confident are you filling out forms by yourself?’ 33 34. Baseline transplant knowledge will be measured by the Kidney Transplant Understanding Tool (K-TUT), while self-efficacy, beliefs of medicine and quality of life will be measured by the Generalised Self-efficacy Scale (GSE), Beliefs About Medicines Questionnaire (BMQ) and Short Form-12 (SF-12) scales, respectively 35–38…”

“…Secondary outcomes include the difference in change in knowledge score between the intervention and control groups, and differences between the intervention and control in the following measures: self-efficacy, beliefs about medications, quality of life, satisfaction with education, adherence to appointments and days in hospital. Knowledge of kidney transplant will be measured by the K-TUT, which has been evaluated in both pretransplant and post-transplant cohorts, and has been shown to have good internal consistency, reproducibility, content and construct validity 35. Self-efficacy will be captured using the GSE which assesses beliefs for coping with difficult demands in life 36.…”

Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan

“…Because a single item was elected by the 5-panel members to be retained, the final set consisted of 20 items. The 20-item questionnaire was pilot-tested in a sample of 20 medical staff at another hospital and 20 individuals from the general public at large [36]. Based on the results of the pilot study, none of the items required modification or deletion from the questionnaire.…”

Effect of an interactive voice response system on self-management in kidney transplant recipients

“…Since post-transplant management is a complex process and KT recipients have a lot to learn, inadequate patient knowledge can easily result in dire consequences (eg, decreased adherence to recommendations and organ rejection). [29,30] We hypothesized that automatic IVRSs designed based on educational and theory-driven intervention which is acceptable to the individual patient would improve self-management in KT recipients who received IVRS compared to patients who only received usual care. Thus, we designed a randomized, 2 parallel groups controlled trial to evaluate the effect of an IVRS intervention on self-management outcomes (such as immunosuppressant medication adherence, transplant knowledge, and quality of life) among KT recipients.…”