Development and psychometric validation of a knowledge–attitude–practice questionnaire on geriatric foot care among clinical nurses

OBJECTIVE: To develop a Knowledge-Attitude-Practice (KAP) questionnaire on geriatric foot care for clinical nurses in China and to evaluate its reliability and validity. METHODS: The questionnaire was developed based on the Knowledge-Attitude-Practice (KAP) framework through a literature review, semi-structured interviews, and two rounds of Delphi expert consultation. After pilot testing, a cross-sectional survey using convenience sampling was conducted among 324 clinical nurses from two tertiary general hospitals in Guizhou Province and Chongqing Municipality, China. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of reliability and validity were performed to examine the psychometric properties of the questionnaire. RESULTS: The final questionnaire comprised 48 items across three dimensions: knowledge, attitude, and practice. Exploratory factor analysis yielded a cumulative variance contribution of 58.314%. Confirmatory factor analysis demonstrated satisfactory model fit (χ²/df = 1.489, GFI = 0.912, AGFI = 0.932, CFI = 0.948, and RMSEA = 0.055). The scale-level content validity index (S-CVI) was 0.93. The overall Cronbach's alpha coefficient was 0.933, and both split-half reliability and test-retest reliability coefficients exceeded 0.80. CONCLUSION: The questionnaire demonstrated satisfactory psychometric properties, with acceptable reliability and validity. It may be useful for assessing clinical nurses' knowledge, attitudes, and practices regarding geriatric foot care and for identifying educational needs in this area.