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These patients are less likely to take their medication, adopt healthy lifestyle changes, or see their physician if their blood pressure is outside the ideal range Atallah et al. While many studies have evaluated patient awareness of hypertension Pereira et al. Developing instruments to assess knowledge is an important step to design effective intervention strategies for the control of BP. Several instruments have been used to evaluate patient knowledge about hypertension Pineiro et al.
The HKT is an easy-to-use questionnaire covering several aspects of hypertension, as its etiology, diagnosis, treatment and prevention. Although in Portugal some studies have evaluated the knowledge of hypertensive patients regarding their disease and the relationship between knowledge and BP control Prior et al.
Thus, the objective of this study was to validate the European-Portuguese adaptation of the Hypertension Knowledge Test questionnaire. Specifically, this study aimed to examine its factorial structure with a confirmatory analysis and to estimate its convergent and construct validities. This was a cross-sectional study. Data were collected in 7 community pharmacies in the central region of Portugal and in the Hospital Infante D. Pedro in Aveiro. HKT comprises the following two parts: 12 true-or-false questions and 9 multiple-choice questions.
The level of knowledge is calculated by assigning one point to each correct answer, obtaining a total score ranging from 0 to A process of translation and back-translation according to international guidelines was performed Guillemin, Bombardier, Beaton, ; Wild et al. The three versions were compared in order to generate a consensus version. The reverse translation, from European-Portuguese to English, was carried out by another bilingual translator who was not involved in developing the initial version and who did not know the objectives and concepts of the study.
This new English version was compared to the original version, and occasional discrepancies were corrected. The patients who participated in this face-validity phase were not further included in the study. After small adjustments based on changes proposed, we obtained the final European-Portuguese version of the HKT. Originally, Batalla was developed to assess patient knowledge regarding hypertension.
It consists of 10 true-or-false questions. One point is attributed to each correct answer, and the final score is calculated by summing the points obtained. Higher scores mean a greater level of consciousness regarding hypertension. The level of adherence is obtained by adding the values of each item and then dividing by the total number of items. Higher scores mean a greater level of adherence.
The classification of patients as adherent or non-adherent is made according scores near the median values.
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Inclusion criteria were adult patients taking at least one antihypertensive drug. All patients who met the inclusion criteria and were being treated by the participating pharmacies and hospital in the study were invited to participate. The interview was conducted by a trained pharmacist in a private office, where data on personal and family history were collected and the HKT-pt-PT, MAT, Strelec, and the Batalla instruments were administered.
According to Kline , samples above participants are considered large and therefore adequate to use analysis such as the CFA. To evaluate overall model fit, we used the chi-square goodness-of-fit statistic, where non-significant values indicate good fit of the model to the data. In addition, we followed the recommendation that other fit indices be used to ascertain model fit Kline, , namely, the comparative fit index CFI , the standardized root-mean-square residual SRMR and the root mean square error of approximation RMSEA.
Model fit is considered adequate or good when the CFI is above 0. The report of the combination of these fit indices has been recommended for a better analysis on the model fit Hu, Bentler, Whenever a model did not fit the data well, the model was inspected for respecification, and alternative models were also tested.
The development of competing models was based on theoretical considerations and analysis of the data. There were patients enrolled in the study.
The mean age was The average time since hypertension diagnosis was In this population, Of the women enrolled, 13 4. The adherence mean score obtained for MAT was 5.
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Table I summarizes the proportion of correct responses to each item. Table II describes the frequencies of answers to the multiple choice questions. The analysis of modification indices and the evaluation of each item phrasing suggested that the introduction of error correlations between items 8 and 11, items 13 and 15 and items 16 and 19 would improve model fit and were included in the model. The values of the alphas if an item was deleted and the item total correlations are reported in Table III. Convergent validity was estimated by correlating the final score of the HKT-pt-PT with other measures assessing the same construct.
A artrite e eu (Portuguese Edition)
Construct validity was estimated by examining differences in adherence based on knowledge of hypertension, as assessed by the HKT-pt-PT score. Based on the median 15 , groups were formed: scores below the mean were considered lower knowledge, and scores above the mean were considered high knowledge.
To our knowledge, this is the first study using confirmatory analysis procedures to examine the factor structure of the HKT, confirming the measurement model of the instrument and the unidimensional theoretical structure of the instrument Kline, Our findings indicate that all the items contribute to the assessment of knowledge on hypertension. The results were presented separately for each study and for the total sample. In the Portuguese version, values of item total correlation ITC range between In study 2 of the original validation, ITC ranged between 0.
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The fact that these items do not contribute much to the final score may be due largely to the high percentage of correct answers that they present. This can be explained by the characteristics of the population surveyed since we applied the instrument to hypertensive patients under treatment, with good levels of adherence. View all copies of this ISBN edition:. Synopsis Chopita Pereda narra sua propria experiencia para, assim, poder ajudar a todos aqueles que, como ella, necessitam encontrar a forma de vencer um ataque de artrite reumatoidea que quase a deixou "em cadeira de rodas ou algo pior".
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