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Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis

Author

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  • Eva K Fenwick
  • Jing Xie
  • Gwyn Rees
  • Robert P Finger
  • Ecosse L Lamoureux

Abstract

Objective: In patients with Type 2 diabetes, to determine the factors associated with diabetes knowledge, derived from Rasch analysis, and compare results with a traditional raw scoring method. Research Design & Methods: Participants in this cross-sectional study underwent a comprehensive clinical and biochemical assessment. Diabetes knowledge (main outcome) was assessed using the Diabetes Knowledge Test (DKT) which was psychometrically validated using Rasch analysis. The relationship between diabetes knowledge and risk factors identified during univariate analyses was examined using multivariable linear regression. The results using raw and Rasch-transformed methods were descriptively compared. Results: 181 patients (mean age±standard deviation = 66.97±9.17 years; 113 (62%) male) were included. Using Rasch-derived DKT scores, those with greater education (β = 1.14; CI: 0.25,2.04, p = 0.013); had seen an ophthalmologist (β = 1.65; CI: 0.63,2.66, p = 0.002), and spoke English at home (β = 1.37; CI: 0.43,2.31, p = 0.005) had significantly better diabetes knowledge than those with less education, had not seen an ophthalmologist and spoke a language other than English, respectively. Patients who were members of the National Diabetes Service Scheme (NDSS) and had seen a diabetes educator also had better diabetes knowledge than their counterparts. Higher HbA1c level was independently associated with worse diabetes knowledge. Using raw measures, access to an ophthalmologist and NDSS membership were not independently associated with diabetes knowledge. Conclusions: Sociodemographic, clinical and service use factors were independently associated with diabetes knowledge based on both raw scores and Rasch-derived scores, which supports the implementation of targeted interventions to improve patients' knowledge. Choice of psychometric analytical method can affect study outcomes and should be considered during intervention development.

Suggested Citation

  • Eva K Fenwick & Jing Xie & Gwyn Rees & Robert P Finger & Ecosse L Lamoureux, 2013. "Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-8, December.
    • Handle: RePEc:plo:pone00:0080593
    DOI: 10.1371/journal.pone.0080593
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    References listed on IDEAS

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    1. Jie Hu & Kenneth J Gruber & Huaping Liu & Hong Zhao & Alexandra A Garcia, 2013. "Diabetes knowledge among older adults with diabetes in Beijing, China," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(1-2), pages 51-60, January.
    2. Charles Lindsey & Simon Sheather, 2010. "Variable selection in linear regression," Stata Journal, StataCorp LP, vol. 10(4), pages 650-669, December.
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    1. Monique F Kilkenny & Libby Dunstan & Doreen Busingye & Tara Purvis & Megan Reyneke & Mary Orgill & Dominique A Cadilhac, 2017. "Knowledge of risk factors for diabetes or cardiovascular disease (CVD) is poor among individuals with risk factors for CVD," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-11, February.

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