Construct development, description and initial validation of the Knowledge about Older Patients Quiz (KOP-Q) for nurses

Background: Literature shows that nurses have a negative attitude toward older patients. Increasing nurses' knowledge (part of attitudes) may affect hospital nurses' attitudes and improve the quality of care for older patients. A first step is understanding nurses' current knowledge. This can be achieved by using a measurement instrument with good validity and reliability. Objectives: This study explains the content development and initial validation of the 'Knowledge about Older Patients Quiz' (KOP-Q) for nurses, describing the first step in developing a valid and reliable instrument. Design: Qualitative method followed by 2 pilot studies. Methods: Open interviews were conducted with 7 scientific experts and 10 nurse specialists in gerontology, geriatrics, and/or nursing and 5 older patients, 70 + with hospital experience in the last two years. The data were analyzed using thematic analysis. Items were generated from literature on themes derived from interviews. A Delphi round with three nurse specialists and two researchers was organized for item reduction. Two pilot survey studies were conducted for measuring readability and face validity of the KOP-Q. Readability was examined by a Dutch language specialist and 7 nurses working on a cardiovascular ward. Face validity was tested in two hospitals with 22 nurses working on geriatric wards. Results: Identified themes were: normal aging, geriatric conditions, signaling problems in old age, interventions, family interventions, vulnerable patients versus older patients and internal motivation for learning and reflection. 185 questions on these themes were developed. After conceptualization, generation and reduction of questions in the Delphi round 52 questions remained eligible for use. Readability and face validity of this initial version of the KOP-Q proved good. Conclusions: Content development of the KOP-Q is of good methodological rigor and each step is carefully described, therefore it can be of use for future diagnostic instrument developers, curriculum developers and educators.