Development and validation of Chinese Health Literacy Scale for Diabetes
Article first published online: 27 NOV 2012
© 2012 Blackwell Publishing Ltd
Journal of Clinical Nursing
Volume 22, Issue 15-16, pages 2090–2099, August 2013
How to Cite
Leung, A. Y., Lou, V. W., Cheung, M. K., Chan, S. S. and Chi, I. (2013), Development and validation of Chinese Health Literacy Scale for Diabetes. Journal of Clinical Nursing, 22: 2090–2099. doi: 10.1111/jocn.12018
- Issue published online: 5 JUL 2013
- Article first published online: 27 NOV 2012
- Manuscript Accepted: 28 JUL 2012
- health promotion;
- psychometric properties;
- scale development;
- type 2 diabetes;
Aims and objectives
To develop and to test the psychometric properties of the Chinese Health Literacy Scale for Diabetes.
Patients with diabetes encounter many challenges when making health decisions in their daily lives, as they have access to many different kinds of health information. Health literacy issues are new topics in Chinese society. Without a valid and reliable instrument in Chinese, it is difficult to measure the level of health literacy and promote the concept of health literacy in Chinese societies.
A methodological study with a sample of 137 patients with type 2 diabetes aged 65 years or older.
Chinese Health Literacy Scale for Diabetes was developed with reference to the revised Bloom's taxonomy model. Psychometric tests (content validity, item analysis, construct validity, discriminative ability and test–retest reliability) were conducted. Correlations between Chinese Health Literacy Scale for Diabetes and four relevant measures were tested. Cronbach's alpha and alpha if item deleted were calculated to assess internal consistency.
Cronbach's alpha for Chinese Health Literacy Scale for Diabetes and its four subscales (remembering, understanding, applying and analysing) were 0·884, 0·885, 0·667, 0·654 and 0·717, respectively. The Chinese Health Literacy Scale for Diabetes was significantly correlated with the Diabetic Knowledge Scale (r = 0·398, p < 0·001), the Diabetic Management Self-Efficacy Scale (r = 0·257, p < 0·001), the Preschool and Primary Chinese Literacy Scale (r = 0·822, p < 0·001) and the Chinese Value of Learning Scale (r = 0·303, p < 0·001). It took an average of seven minutes to complete this 34-item instrument.
The findings of this study support the Chinese Health Literacy Scale for Diabetes as a reliable and valid instrument for measuring the health literacy of Chinese patients with diabetes.
Relevance to clinical practice
We recommend that clinicians use this tool to assess patients' health literacy before conducting any kind of health promotion.