Development, Reliability, and Validity of the“Knowledge-Attitude-Practice” Questionnaire of Foreigners on Traditional Chinese Medicine Treatment

Abstract

Objective. To develop a “knowledge-attitude-practice” questionnaire as an evaluating tool of foreigners’ cognition on TCM treatment, so as to promote the internationalization of TCM. Methods. The questionnaire was based on the “knowledge-attitude-practice” model and adjusted by expert consultation using the Delphi method. After conducting a survey among foreigners, Cronbach’s $\alpha$ and exploratory factor analysis were used to test the internal consistency reliability and structural validity of the questionnaire, respectively. Results. A total of 10 experts participated in two rounds of expert consultation. The recovery rates of two rounds of expert consultation form were 100.0%. The coefficient authority in two rounds of expert consultation was 0.87 and 0.88, respectively. The concentration of expert opinions in the knowledge, attitude, and practice dimensions was 3.80 to 4.70 points, 3.70 to 4.50 points, and 3.60 to 4.40 points, respectively, in the first round and 4.30 to 4.80 points, 4.10 to 4.60 points, and 4.00 to 4.50 points, respectively, in the second round. The coefficient of variation in the knowledge, attitude, and practice dimensions was 0.10–0.32, 0.16–0.29, and 0.19–0.35, respectively, in the first round and 0.09–0.19, 0.15–0.25, and 0.16–0.31, respectively, in the second round. The W value and significance test $x^2$ in the first round were 0.657 and 218.620 while those in the second round were 0.671 and 181.181 $\left(P<0.001\right)$ . 8 items were deleted and 1 item was added, and other reserved items were modified according to the statistical analysis results of evaluation items and expert suggestions after the first round and there were no changes after the second round. The revised questionnaire includes three dimensions of knowledge, attitude, and practice, with a total of 30 items. After translating the questionnaire into English, it was conducted in 176 foreigners. Cronbach’s $\alpha$ coefficient of the total questionnaire, knowledge dimension, attitude dimension, and practice dimension was 0.908, 0.781, 0.823, and 0.918, respectively. Exploratory factor analysis extracted 3 factors with a cumulative contribution of 54.090%. After testing reliability and validity, 1 item was deleted, leaving 29 items. Conclusions. After two rounds of expert consultation based on the Delphi method, the results of expert authority, expert coordination, and expert opinions’ concentration were promising, and the expert consultation results were reliable. The “knowledge-attitude-practice” questionnaire of foreigners on TCM treatment in English had good reliability and validity and can evaluate foreigners’ cognition on TCM treatment.