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Dementia knowledge assessment scale (DKAS): confirmatory factor analysis and comparative subscale scores among an international cohort


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Annear, MJ ORCID: 0000-0003-4474-2543, Toye, C, Elliott, KJ ORCID: 0000-0002-4726-5685, McInerney, F ORCID: 0000-0003-1781-402X, Eccleston, C ORCID: 0000-0002-7913-6888 and Robinson, A 2017 , 'Dementia knowledge assessment scale (DKAS): confirmatory factor analysis and comparative subscale scores among an international cohort' , BMC Geriatrics, vol. 17 , pp. 1-11 , doi: 10.1186/s12877-017-0552-y.

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Background: Dementia is a life-limiting condition that is increasing in global prevalence in line with populationageing. In this context, it is necessary to accurately measure dementia knowledge across a spectrum of healthprofessional and lay populations with the aim of informing targeted educational interventions and improvingliteracy, care, and support.Building on prior exploratory analysis, which informed the development of the preliminarily valid and reliable versionof the Dementia Knowledge Assessment Scale (DKAS), a Confirmatory Factor Analysis (CFA) was performed to affirmconstruct validity and proposed subscales to further increase the measure’s utility for academics and educators.Methods: A large, de novo sample of 3649 volunteer respondents to a dementia-related online course was recruitedto evaluate the performance of the DKAS and its proposed subscales. Respondents represented diverse cohorts,including health professionals, students, and members of the general public. Analyses included CFA (using structuralequation modelling), measures of internal consistency (α), and non-parametric tests of subscale correlation (SpearmanCorrelation) and score differences between cohorts (Kruskal-Wallis one-way analysis of variance).Results: Findings of the CFA supported a 25-item, four-factor model for the DKAS with two items removed due to poorperformance and one item moved between factors. The resultant model exhibited good reliability (α = .85; ωh = .87;overall scale), with acceptable subscale internal consistency (α ≥ .65; subscales). Subscales showed acceptable correlationwithout any indication of redundancy. Finally, total and DKAS subscale scores showed good discrimination betweencohorts of respondents who would be anticipated to hold different levels of knowledge on the basis of education orexperience related to dementia.Conclusion: The DKAS has been confirmed as a reliable and valid measure of dementia knowledge for diversepopulations that is capable of elucidating knowledge characteristics across four coherent domains: 1) Causes andCharacteristics, 2) Communication and Behaviour, 3) Care Considerations, and 4) Risks and Health Promotion. Importantly,the four confirmed subscales clearly distinguish between groups who might be expected to hold differing levels ofknowledge about dementia, allowing for a fine-grained level of detail to be established when evaluating baselineunderstanding or knowledge change associated with educational intervention.

Item Type: Article
Authors/Creators:Annear, MJ and Toye, C and Elliott, KJ and McInerney, F and Eccleston, C and Robinson, A
Keywords: Dementia, Knowledge, DKAS, Confirmatory factor analysis, Scale psychometrics
Journal or Publication Title: BMC Geriatrics
Publisher: BioMed Central
ISSN: 1471-2318
DOI / ID Number: 10.1186/s12877-017-0552-y
Copyright Information:

Copyright 2017 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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