PDF(Pubmed)
Abstract：
The transition from in-person to digital preoperative patient education requires effective methods for evaluating patients\' understanding of the perioperative process, risks, and instructions to ensure informed consent. A knowledge questionnaire covering different anaesthesia techniques and instructions could fulfil this need. We constructed a set of items covering common anaesthesia techniques requiring informed consent and developed the Rotterdam Anaesthesia Knowledge Questionnaire (RAKQ) using a structured approach and Item Response Theory. A team of anaesthetists and educational experts developed the initial set of 60 multiple-choice items, ensuring content and face validity. Next, based on exploratory factor analysis, we identified seven domains: General Anaesthesia-I (regarding what to expect), General Anaesthesia-II (regarding the risks), Spinal Anaesthesia, Epidural Anaesthesia, Regional Anaesthesia, Procedural sedation and analgesia, and Generic Items. This itemset was filled out by 577 patients in the Erasmus MC, Rotterdam, and Albert Schweitzer Hospital, Dordrecht, the Netherlands. Based on factor loadings (≥0.25) and considering clinical relevance this initial item set was reduced to 50 items, distributed over the seven domains. Each domain was processed to produce a separate questionnaire. Through an iterative process of item selection to ensure that the questionnaires met the criteria for Item Response Theory modelling, 40 items remained in the definitive set of seven questionnaires. Finally, we developed an Item Response Theory model for each questionnaire and evaluated its reliability. 1-PL and 2-PL models were chosen based on best model fit. No item misfit (S-χ2, p<0.001 = misfit) was detected in the final models. The newly developed RAKQ allows practitioners to assess their patients\' knowledge before consultation to better address knowledge gaps during consultation. Moreover, they can decide whether the level of knowledge is sufficient to obtain digital informed consent without face-to-face education. Researchers can use the RAKQ to compare new methods of patient education with traditional methods.
摘要：
从术前患者教育到数字化的转变需要有效的方法来评估患者对围手术期过程的理解，风险,以及确保知情同意的指示。涵盖不同麻醉技术和说明的知识问卷可以满足这一需求。我们构建了一组涵盖需要知情同意的常见麻醉技术的项目，并使用结构化方法和项目反应理论开发了鹿特丹麻醉知识问卷（RAKQ）。一组麻醉师和教育专家开发了最初的60项多项选择项目，确保内容和面部有效性。接下来,基于探索性因素分析，我们确定了七个领域：全身麻醉-I(关于期待什么)，全身麻醉-II（关于风险），脊柱麻醉,硬膜外麻醉,区域麻醉,程序性镇静和镇痛，和通用项目。该项目由伊拉斯谟MC的577名患者填写，鹿特丹,和AlbertSchweitzer医院,多德雷赫特,荷兰。基于因子负荷（≥0.25）并考虑临床相关性，该初始项目集减少到50个项目，分布在七个领域。处理每个域以产生单独的问卷。通过项目选择的迭代过程，以确保问卷符合项目反应理论建模的标准，最终的七份问卷中仍有40个项目。最后,我们为每个问卷建立了项目反应理论模型，并评估了其可靠性。基于最佳模型拟合选择1-PL和2-PL模型。在最终模型中未检测到项目失配(S-χ2,p<0.001=失配)。新开发的RAKQ允许从业者在咨询之前评估他们的患者知识，以更好地解决咨询期间的知识差距。此外，他们可以决定知识水平是否足以在没有面对面教育的情况下获得数字知情同意。研究人员可以使用RAKQ将患者教育的新方法与传统方法进行比较。
