Measuring dementia knowledge and attitudes among the German Deaf community: Adaptation and validation of the Knowledge Assessment Scale, the Dementia Attitude Scale, and the Confidence in Dementia Scale in German Sign Language

BackgroundDeaf individuals face barriers in accessing healthcare for dementia and Alzheimer's disease and are often overlooked in research. Deaf-friendly scales in German Sign Language (DGS) are urgently needed to ensure inclusive and equitable dementia care for Deaf individuals.ObjectiveThe aim of the study is the linguistic and cultural adaptation/validation of the Dementia Knowledge Assessment Scale (DKAS-D), the Dementia Attitude Scale (DAS-D), and the Confidence in Dementia Care Scale (CODE-D) into DGS.MethodThe three scales were adapted into DGS using a collaborative translation process involving Deaf and hearing bilingual signers. A convenience sample of 205 Deaf participants answered the DKAS-DGS and DAS-DGS; a subsample answered the CODE-DGS (n = 160) online via Google Forms or as a pencil-and-paper version in person. Psychometric validation included internal consistency, structural and construct validity. For the DKAS-DGS an item analysis was conducted.ResultsInternal consistency was acceptable to good for all scales. The removal of five items from the DKAS-DGS and four from the DAS-DGS led to improvements in structural validity for both. The CODE-DGS one-factor structure showed good model fit. Construct validity was confirmed, with participants with practical or professional experience with people living with dementia scoring higher on all scales. Item analysis of the DKAS-DGS revealed challenges in translation, as well as the need for accessible, tailored dementia education for the Deaf community.ConclusionsThe three scales are valuable tools for measuring dementia knowledge, attitudes, and confidence in care among DGS-signers and may be used in future research settings.