Original Investigation
Development and Results of a Kidney Disease Knowledge Survey Given to Patients With CKD

https://doi.org/10.1053/j.ajkd.2010.09.018Get rights and content

Background

Little is known about disease-specific knowledge in patients with chronic kidney disease (CKD). We developed and examined the results of a survey to characterize kidney disease knowledge.

Design

Survey about kidney disease knowledge, with questions developed by experts.

Setting & Participants

401 adult patients with CKD (stages 1-5) attending a nephrology clinic from April-October 2009.

Outcomes & Measurements

We calculated survey reliability using the Kuder-Richardson-20 coefficient and established construct validity by testing a priori hypotheses of associations between survey results and patient characteristics. We descriptively analyzed survey responses and applied linear regression analyses to evaluate associations with patient characteristics. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine.

Results

Participants' median age was 58 (25th-75th percentile, 46-68) years, 83% were white, 18% had limited literacy, and 77% had CKD stages 3-5. The 28-question knowledge survey had good reliability (Kuder-Richardson-20 coefficient = 0.72), and mean knowledge score was 66% ± 15% (SD). In support of the construct validity of our knowledge survey, bivariate analysis shows that scores were associated with age (β = −0.01/10 years; 95% CI, −0.02 to −0.005; P = 0.003), formal education (β = 0.09; 95% CI, 0.03-0.15; P = 0.004), health literacy (β = 0.06; 95% CI, 0.03-0.10; P = 0.001), kidney education class participation (β = 0.05; 95% CI, 0.01-0.09; P = 0.009), knowing someone else with CKD (β = 0.05; 95% CI, 0.02-0.08; P = 0.001), and awareness of one's own CKD diagnosis (β = 0.07; 95% CI, 0.04-0.10; P < 0.001). Findings were similar in adjusted analyses.

Limitations

Recruitment from 1 clinic limits generalizability of findings.

Conclusions

For patients with CKD, this Kidney Knowledge Survey (KiKS) is reliable and valid and identifies areas of and risk factors for poor kidney knowledge. Further study is needed to determine the impact of CKD knowledge on self-care behaviors and clinical outcomes.

Section snippets

Survey Development

We developed a survey to assess kidney disease knowledge in a stepwise fashion. A priori, we developed survey questions to represent knowledge about topics important to kidney disease management. Approximately 100 questions were generated first to maximize content relevant to kidney knowledge. These content areas included functions of the kidney, treatment options for kidney failure, signs and symptoms of disease progression, medications of potential benefit or harm to the kidney, blood

Participant Characteristics

Four hundred six consecutive consenting patients were recruited from a nephrology specialty clinic (67% response rate). The most common reason for not participating was insufficient time. We do not have information about nonparticipants. The survey took an average of 25 minutes to complete. Five participants withdrew because of illness (n = 2), not wanting to finish (n = 1), and time (n = 2), leaving 401 participants.

Overall, participants had a median age of 58 (25th-75th percentile, 46-68)

Discussion

Using a systematic method of survey design, development, administration, and analysis, we have created an instrument that is valid and reliable in measuring disease-specific knowledge in patients with CKD. The reliability calculated for our knowledge survey is similar to other knowledge scales in similar populations (hemodialysis)14, 19 and patients with other chronic diseases.44 KiKS performed as expected with our a priori model and showed bivariate associations similar to those found in

Acknowledgements

Support: This work was supported in part by T32 DK007569 and a Clinical Scientist in Nephrology Fellowship Grant from the American Kidney Fund (to Dr Wright). Additional support was provided by the National Institute of Diabetes and Digestive and Kidney Diseases by awards K23DK080952 and K23DK080952-02S1 (Dr Cavanaugh), K24DK77875 and P60DK020593 (Dr Elasy), and K24DK062849 (Dr Ikizler). The funding agencies did not have a role in the design, conduct, or reporting of the study.

Financial

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    Originally published online December 20, 2010.

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