The development of a reliable and valid instrument to measure the osteoporosis-related knowledge: validation of the Hungarian version of Osteoporosis Knowledge Assessment Tool (OKAT)

Osteoporosis Knowledge Assessment Tool - Tamil (OKAT-T) in postmenopausal women: A validity and reliability study

Introduction

Osteoporosis is a silent disease that is more prevalent among postmenopausal women (PMW) due to hormonal transition. Various toolkits, including the Osteoporosis Knowledge Assessment Tool (OKAT), were available for the knowledge assessment. The Osteoporosis-related knowledge is crucial for preventing osteoporosis, but there is no validated, reliable questionnaire in Tamil to measure this knowledge.

Aim

To validate the Tamil version of the OKAT (OKAT-T) and its psychometric properties to measure the knowledge of osteoporosis for use in postmenopausal women.

Methodology

This cross-sectional study was done in two phases, as translation of OKAT in Tamil and validation of OKAT-T among 430 postmenopausal women in both rural and urban regions. Reliability was examined by the Flesch reading ease (FKRE&G) and McNemar's test, along with difficulty index, item discrimination and item-total correlations, inter-item consistency (Cronbach's alpha coefficient).

Result

The overall mean age of the 430 PMW was 59.53 ± 9.83 years. The results showed a good and satisfactory face validity and FKRE&G score (55.9). The Cronbach's alpha for the overall scale was calculated as 0.85 and considered to be good and satisfactory. As per the difficulty index, 19 items had a 0.3 to 0.7, implying that the questionnaire was easy to understand and satisfactory. Similarly, a test-retest was assessed, which was statistically significant for only six items out of 26, showing that the tool has stable reliability.

Conclusion

The management of chronic disorders such as osteoporosis has become more challenging for patients especially among PMW and healthcare professionals due to the increasing life expectancy and urbanization. The use of an Osteoporosis Knowledge Assessment tool that has been tailored to people's understanding and developed in the local language can raise awareness levels about osteoporosis, encourage the adoption of osteoprotective strategies, and provide guidance on treatment options.

Osteoporosis Knowledge and Its Risk Factors in Older Adults With Upper Extremity Fragility Fractures: A National Cross-Sectional Study

It is crucial to recognize upper extremity fragility fractures as sentinel events that allow healthcare professionals the opportunity to identify and address underlying factors contributing to poor bone health, thereby reducing the risk of future fragility fractures. This study seeks to evaluate the extent of understanding and factors influencing osteoporosis in older adults with upper extremity fragility fractures, aiming to establish a foundation for enhancing their comprehension. A total of 1443 participants in 31 provinces were included in this study as survey subjects from September to November 2023. A general information questionnaire and an osteoporosis knowledge assessment tool were used for a cross-sectional survey. The univariate analysis and logistic regression were used to analyze the risk factors. The score of osteoporosis knowledge assessment tool of participants was 10.00 (7.00, 12.00), with only 24.95% scoring above 12 points. Being in an eastern hospital, suffering from chronic obstructive pulmonary disease, being diagnosed as severe osteoporosis, having bone mineral density testing, receiving osteoporosis health education, and receiving health education by phone were associated with higher knowledge of osteoporosis. The osteoporosis knowledge of older adults with upper extremity fragility fractures needs to be improved. To help the secondary prevention of osteoporosis, the standardized osteoporosis health education should be strengthened, and attention should be paid to key groups.

Socio-Economic and Health Literacy Inequalities as Determinants of Women's Knowledge about Their Reproductive System: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

To support women's informed decisions and reproductive self-care, confident reproductive health-related knowledge is needed, supported by adequate health literacy (HL). No corresponding survey has been carried out in Hungary on inequalities to provide information addressing education.

MATERIALS AND METHODS

In the current cross-sectional online survey, 301 women of reproductive age (27.16 ± 0.36 years) were asked with the Hungarian versions of validated and standardised questionnaires about reproductive knowledge on hormones, ovulation, menstrual cycle, pregnancy signs and birth control (Knowledge of Female Body Scale-KFB), and HL (Brief Health Literacy Screening Tool-BRIEF). Spearman correlation and multivariable linear regression analyses were utilised, with a significance level set at p < 0.05. IBM SPSS version 28.0 (IBM SPSS, Armonk, NY, USA: IBM Corp.) and G*Power (version 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) software. The STROBE checklist was followed. The Clinical Trial Registry Nr. is NCT06146673.

RESULTS

The KFB composite score was high (20.01 ± 2.33); 86.374% had "high knowledge". Still, lacking information was identified for the mechanisms of certain contraceptive methods and early physical signs of pregnancy. A significant difference was also found in the KFB scores in the case of higher age (p = 0.019), higher education level (p = 0.018) and previous live birth (p = 0.028). A positive correlation was found between KFB and HL (p < 0.001), education (p = 0.005), and age (p = 0.021). A multiple regression analysis (R2 = 0.087, p < 0.001) indicated that both HL (p < 0.001) and age (p = 0.003) are potential positive predictors of adequate reproductive knowledge, whereas induced abortion (p = 0.013) might serve as an inverse predictor.

CONCLUSIONS

Inequalities in women's knowledge about their reproductive system and HL were found, and it was significantly the lowest in their highest conception probability age. Therefore, in addition to targeted education, HL also needs improvement.

Questionnaires assessing knowledge and beliefs about musculoskeletal conditions are potentially suitable for use, but further research is needed: a systematic review

OBJECTIVES

To evaluate the measurement properties of Patient-reported outcome measures (PROMs) for knowledge and/or beliefs about musculoskeletal conditions.

STUDY DESIGN AND SETTING

A systematic review was performed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. This review was prospectively registered on PROSPERO - ID: CRD42022303111. Electronic databases, reference lists, forward citation tracking, and contact with experts were used to identify studies. Eligible studies were reports developing or assessing a measurement property of a PROM measuring musculoskeletal condition specific-knowledge and/or beliefs. We assessed the methodological quality and measurement properties of included studies. A modified Grading of Recommendations Assessment Development and Evaluation approach was used to rate the quality of evidence for each PROM.

RESULTS

The literature search was performed from inception to 11th September 2023. Sixty records were included, reporting 290 individual studies, and provided information on 25 PROMs. Five PROMs presented sufficient structural validity, three presented sufficient cross-cultural validity, ten presented sufficient reliability, three presented sufficient criterion validity, six presented sufficient hypothesis-testing, and four presented sufficient responsiveness. No PROM presented sufficient evidence for content validity, internal consistency, and measurement error. Based on the available evidence, no PROM was classified as suitable for use according to the COSMIN recommendations. Twenty-four PROMs are potentially suitable for use, and one PROM is not recommended for use.

CONCLUSION

No PROM designed to assess knowledge and/or beliefs about musculoskeletal conditions meets the COSMIN criteria of suitable for use. Most PROMs identified in this systematic review were considered as potentially suitable for use and need further high-quality research to assess their measurement properties.

When is a fracture not just a fracture? Exploring emergency nurses' knowledge of osteoporosis in the West of Ireland

BACKGROUND

Osteoporosis and fragility fractures are set to rise with the global ageing population. Prevalence will continue to significantly impact people's quality of life and healthcare expenditure. Emergency nurses are ideally placed to highlight the importance of screening, and treatment, to the public. For emergency nurses to impart information to patients it is essential they have accurate, evidence-based knowledge. This study aims to determine if emergency nurses' knowledge of osteoporosis is sufficient to educate the public.

METHOD

A cross sectional descriptive design of 210 emergency nurses using the 'Osteoporosis Knowledge Questionnaire' (OKQ) was administered in four hospitals in the West of Ireland. Data was analysed using SPSS v28.

RESULTS

A 66 % response rate was achieved. The mean score on the OKQ was 12.13 out of a possible 22. This suggests emergency nurses' knowledge of osteoporosis is substandard. Level of education has the greatest impact on participants (p = 0.005). Results indicated that emergency nurses acknowledge their responsibility regarding health promotion but lack the knowledge to undertake the role.

CONCLUSION

Emergency nurses play a pivotal role in reducing osteoporosis and fragility fractures, by disseminating information to patients on prevention and management. This study highlighted that educational initiatives are required to address the deficiencies amongst emergency nurses' understanding of osteoporosis. Enhancing knowledge will inevitably lead to increased public awareness in tackling this global health crisis.

Translation and cross-cultural adaptation of Osteoporosis Knowledge Assessment Tool (OKAT) for Chinese populations in Australia

The increased prevalence of osteoporosis among Chinese-speaking communities in Australia deemed it necessary to have a culturally appropriate tool for assessing knowledge. This study describes the cultural adaption of the validated Osteoporosis Knowledge Assessment Tool (OKAT). The adapted tool is readable and understandable for diverse Chinese-speaking communities.

PURPOSE

With an expected increasing prevalence of osteoporosis among Chinese-speaking communities in Australia, a cross-culturally adapted questionnaire is necessary to assess knowledge levels among the group. We aimed to cross-culturally adapt the Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire for Chinese-speaking populations in Australia.

METHODS

Cross-cultural adaptation guidelines were employed to culturally adapt the OKAT to simplified Chinese. This involved translation, revision, retroversion, and expert discussion before finalizing the Chinese version of OKAT. The participants were recruited through convenience sampling from a cohort of Chinese-speaking populations who attended a bone health promotion program. The adapted questionnaire was piloted with Chinese-speaking communities in the Greater Western Sydney area for face and content validity. The adapted questionnaire was compared with the original version for response agreement using Cohen's kappa goodness of fit. The face validity of the adapted tool was analysed through a binary scale rating for readability and understandability.

RESULTS

The cross-culturally adapted version of OKAT has a 71.8% total response agreement with the original version of OKAT. The cross-culturally adapted OKAT yielded higher total scores than the translated version. The cross-culturally adapted tool had a good face and content validity.

CONCLUSION

The cross-culturally adapted version of OKAT improves the overall readability and understandability of the questionnaire among Chinese-speaking populations in Australia.

An osteoporosis knowledge assessment instrument - development and validation

INTRODUCTION

The consequences of osteoporotic fractures are extremely detrimental to the individual as well as to society. Adopting effective preventative measures is a top public health priority.

Knowledge of osteoporosis prevention among people with endocrine disorders: A cross-sectional study

People with endocrine disorders are at an increased risk of osteoporosis, yet their knowledge of osteoporosis prevention is rarely studied. This study aimed to assess the knowledge related to osteoporosis prevention and its associated factors among people with endocrine disorders in China. A cross-sectional study was conducted in a Chinese hospital's Department of Metabolism and Endocrinology. A total of 562 people with endocrine disorders completed the Chinese version of the Osteoporosis Prevention and Awareness Tool to assess their knowledge of osteoporosis prevention. Results showed that participants had a mean knowledge of 59.36 ± 23.90 out of 100, with only 52.1% scoring above 60 points. Being female, having higher education, with comorbidities, with a recent osteoporosis diagnosis, and having received health education related to osteoporosis prevention were associated with higher knowledge of osteoporosis prevention. Our study indicates that more efforts are needed to improve the knowledge related to osteoporosis prevention among people with endocrine disorders. This may be realized by strengthening and expanding diverse education, focusing on males and those with lower education and without comorbidities.

Development and Validation of India-specific Hindi Version of Osteoporosis Knowledge Assessment Tool

Purpose

Patient education is one of the important components of reducing the morbidity of osteoporosis. The aim of this study is to validate the Hindi version of the Osteoporosis Knowledge Assessment Tool (OKAT-H) among a hospital-based sample in the age group of 18-44 years of age.

Methods

The study was conducted in two phases - translation and adaption of the OKAT in Hindi followed by its validation. The translated tool was analyzed by Flesch reading ease, McNemar test, Cronbach alpha, difficulty index, discrimination index, and principal factor analysis.

Results

Two hundred and sixty women with a mean age of 28.3 ± 17.2 years were enrolled in the study. The mean score of the OKAT-H tool obtained in the study was 11.3 ± 2.1. A significant difference was noted in the scores based on educational qualification or with any family history of either osteoporosis or fracture (P < 0.05). The Flesch score for the OKAT-H tool was 86. Inter-item correlation for all the items ranged between 0.15 and 0.5. The Cronbach's alpha measured 0.892 suggesting high internal consistency. Items number 6, 7, 8, 9, 13, and 14 showed a significant difference on the McNemar test questioning its consistency on test-retest.

Conclusion

A new shorter version of the tool may be developed since six items showed low consistency. The use of such an instrument in local language would help spread awareness about the disease as well as help the population in adopting osteoprotective strategies and also to seek help and advice regarding treatment.

Assessment of osteoporosis knowledge, awareness, and risk factors among premenopausal and postmenopausal women from Jordan: a cross-sectional study

RATIONALE

Lack of information about osteoporosis knowledge and awareness among premenopausal compared to postmenopausal women in Jordan.

MAIN RESULT

Women had an average-poor knowledge and awareness about osteoporosis.

SIGNIFICANCE

This study highlights the need to improve women's knowledge about osteoporosis, its consequences, potential risk factors, preventive measures, and treatment options.

PURPOSE

To assess osteoporosis knowledge, awareness, and risk factor profile among premenopausal and postmenopausal women from Jordan.

METHODS

This was a cross-sectional study that involved 490 premenopausal and 488 postmenopausal women from the general population of Jordan. Face-to-face interviews were conducted to collect the sociodemographic and clinical data and to complete the Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire.

RESULTS

Premenopausal and postmenopausal women had an average-poor level of knowledge and awareness regarding osteoporosis, with a total mean score of 51.3 and 50.9, respectively, out of the total OKAT score of 100. More than 50% of premenopausal women correctly answered 11 questions, while >50% of postmenopausal women correctly answered 9 questions out of 20 in OKAT, which are related to knowledge and awareness about osteoporosis. The participants' marital status (being married), higher educational level, and higher economic status were significantly associated with better knowledge and awareness about osteoporosis (p-values < 0.05). Postmenopausal women had higher osteoporosis risk profile including older age, higher body mass index, less regular exercise, and less exposure to sunlight versus premenopausal women.

CONCLUSION

Premenopausal and postmenopausal women from Jordan had an average-poor level of knowledge and awareness about osteoporosis. Higher educational levels and higher income are associated with better knowledge and awareness about osteoporosis. It is therefore crucial to improve the knowledge of women in Jordan about osteoporosis and its consequences, as well as the potential risk factors, preventive measures, and treatment options. Conducting periodic osteoporosis awareness and educational campaigns are necessary to spread the awareness of the disease.