Development of the Diabetes Knowledge (DKN) Scales: Forms DKNA, DKNB, and DKNC

Abstract

The Diabetes Knowledge Assessment (DKN) scales were developed to meet a specific need for rapid and reliable knowledge assessment in diabetic patients. Item format and item selection from an initial pool of 89 items were determined by pilot-testing over 300 diabetic subjects. Reliability analysis of the resulting 40 multiple-choice items, with a further sample of 56 subjects, gave a Cronbach's alpha coefficient of 0.92. Parallel forms DKNA, DKNB, and DKNC, each of 15 items selected from the parent set, had alpha coefficients above 0.82 and correlated 0.90 with each other. A full clinical trial, using DKNA, DKNB, and DKNC in randomized order of presentation, was conducted with 219 subjects attending a 2-day diabetes education program. Overall DKN scores improved from 7.6 (51%) to 11.3 (75%). Analysis of variance confirmed that DKNA, DKNB, and DKNC were equivalent forms at pretest. Mean posttest scores on DKNB were lower than the other scales (P less than 0.001), but variances were equivalent for all three. A specific local change in the education program format was found to account for this discrepancy in the DKNB posttest mean. In situations where comprehensive assessment of diabetes knowledge would be time-consuming and unnecessary, these results indicate that rapid and reliable assessment is possible with a scale of only 15 validated items. The development of parallel forms of the scale extends the range of retesting possibilities for diagnosis and research.

Preliminary experience with the Internet release of AIDA—an interactive educational diabetes simulator

“…If encouraging results were obtained with this-further more rigorous, better randomised studies (with stratification) could be considered. Detailed questionnaires have also not been included because numerous such questionnaires can already be found in the diabetes education literature [17][18][19][20][21][22]. Furthermore, the exact questions asked of users may subtly vary depending on the exact scope of the software program being evaluated.…”

“…Various standard questionnaires are available for assessing diabetes knowledge, behaviour, and self-care [17][18][19][20][21][22]. In addition to these a series of specific scenarios testing the sort of concepts that users would be expected to learn from the simulator under review would also need to be included (e.g.…”

“…The purpose of this paper is to present feedback experience obtained from the Internet release of one particular interactive educational diabetes simulator-called AIDA [14][15][16]-and outline in detail a protocol design which could be adopted, together with standard questionnaires [17][18][19][20][21][22], for the prospective and objective evaluation of such an educational tool.…”

Knowledge of gestational diabetes among a multi-ethnic cohort in Australia

“…Final questions centred on three main areas: (1) general knowledge of GDM, including associated complications and likely clinical management; (2) maternal understanding of diet, food values and exercise in relation to GDM management and (3) maternal understanding of normal blood glucose readings. In terms of validity, the Diabetes Knowledge Scale [DKN]- (Dunn et al, 1984) is a well known and validated instrument, and it is considered to have a Cronbach's alpha coefficient of 0.92 (Dunn et al, (1984). Some minor modification of this questionnaire was undertaken in a bid to make the instrument more sensitive to gestational diabetes.…”

“…It was not possible to locate a questionnaire which dealt specifically with gestational diabetes and thus the Diabetes Knowledge Scale [DKN], (Dunn et al 1984) was used together with an additional seven questions focussing specifically on pregnancy and gestational diabetes. These questions were developed in consultation with a group of experienced health professionals including a diabetes nurse educator, an endocrinologist, an obstetrician, a midwife and a hospital based interpreter.…”