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      A Short Knowledge Assessment Tool Is Valid and Acceptable for Adults with Inflammatory Bowel Disease

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          Abstract

          Background

          For people with inflammatory bowel disease, validated knowledge questionnaires are valuable to identify gaps in understanding and explore the impact on disease variables.

          Aims

          The aim of this study was to validate the short knowledge questionnaire Inflammatory Bowel Disease Knowledge Inventory Device 2, known as IBD-KID2, for use with adults with inflammatory bowel disease.

          Methods

          Concurrent validity of IBD-KID2 was assessed by comparing scores with those achieved on the Crohn’s and Colitis Knowledge Score (CCKNOW). IBD-KID2 reliability was assessed with test–retest completion at two time points, generalizability assessed by comparing IBD-KID2 cohort scores at different recruitment centres, and acceptability assessed using participant survey.

          Results

          Seventy-five adults with inflammatory bowel disease completed the study. The mean percentage scores achieved on the IBD-KID2 and CCKNOW were 72.8% (SD 16.0) and 49.7% (SD 18.2), respectively. There was a significant correlation between IBD-KID2 and CCKNOW scores ( R 0.573, P < 0.005), confirming concurrent validity. IBD-KID2 reliability was confirmed as no significant difference was seen between scores at test and retest (mean difference −0.2, P = 0.92). Generalizability was established as no significant score difference was seen between recruitment centres after controlling for population differences. The acceptability survey showed that 49 (69%) participants preferred IBD-KID2 to the CCKNOW, 60 (85%) found the IBD-KID2 easier to complete, and 38 (53%) considered the CCKNOW as most suitable for adults.

          Conclusions

          IBD-KID2 is a valid, reliable, and generalizable tool for measuring knowledge in adults with inflammatory bowel disease with good acceptability. IBD-KID2 is easy and quick to complete, hence limiting respondent burden.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s10620-022-07507-7.

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          Most cited references34

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          Three approaches to qualitative content analysis.

          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

            Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis.
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              Nonadherence in inflammatory bowel disease: results of factor analysis.

              The purpose of the study was to assess overall nonadherence to treatment among patients with Crohn's disease (CD) and ulcerative colitis (UC) in a single tertiary center. A total of 177 patients were enrolled in this study (84 males, 93 females; 117 CD, 60 UC). Patients were interviewed about their nonadherent behavior and their answers were analyzed using factor analysis. Urine samples were collected from a subcohort of 47 patients treated by mesalamine to verify the presence of 5-ASA or its metabolites. Overall intentional nonadherence was reported by 38.9% of patients; 18.6% of the patients discontinued the treatment at least once. Intentional dose reduction was reported by 18% of patients; 14.7% of patients occasionally did not refill their medications on time. There were no differences in adherence between males and females, disease type, previous bowel surgery, or marital, smoking, and nonsmoking status. More than 38% of patients reported unintentional nonadherence. Factor analysis proved that nonadherence increased with a higher education level of the patients and decreased with older age. Adverse drug effects strongly contributed to nonadherence. Nonadherent patients were more likely to be chronically active or in relapse (tau = 0.212; P = 0.002). In the group of 47 patients whose urine was analyzed, 6 cases (12.7%) were negative for mesalamine or its metabolite. The overall intentional nonadherence with medical therapy is relatively high among IBD patients and should be taken into account when a patient's response to treatment is unsatisfactory. Therefore, problems of nonadherence should be discussed with all IBD patients.
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                Author and article information

                Contributors
                katrin.buerkle@otago.ac.nz
                angharad.hurley@otago.ac.nz
                Christine.Ho@southerndhb.govt.nz
                michael.schultz@otago.ac.nz
                andrew.day@otago.ac.nz
                Journal
                Dig Dis Sci
                Dig Dis Sci
                Digestive Diseases and Sciences
                Springer US (New York )
                0163-2116
                1573-2568
                5 May 2022
                5 May 2022
                : 1-10
                Affiliations
                [1 ]GRID grid.29980.3a, ISNI 0000 0004 1936 7830, Department of Medicine, , University of Otago (Dunedin), ; PO Box 56, Dunedin, 9054 New Zealand
                [2 ]GRID grid.29980.3a, ISNI 0000 0004 1936 7830, Department of Paediatrics, , University of Otago (Christchurch), ; Riccarton Ave, Christchurch, 8011 New Zealand
                [3 ]GRID grid.508100.c, ISNI 0000 0000 9159 3497, Gastroenterology Department, , Southern District Health Board, ; Private Bag 1921, Dunedin, 9054 New Zealand
                Author information
                http://orcid.org/0000-0003-2290-7386
                Article
                7507
                10.1007/s10620-022-07507-7
                9068503
                35511411
                25a4d0db-eff9-4812-8649-6b076a3dd88e
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 2 November 2021
                : 28 March 2022
                Funding
                Funded by: University of Otago
                Categories
                Original Article

                Gastroenterology & Hepatology
                inflammatory bowel disease,crohn’s disease,ulcerative colitis,knowledge questionnaire,concurrent validity,reliability,ibd-kid2

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