Development and validation of Chinese Health Literacy Scale for Diabetes

Authors

  • Angela YM Leung PhD, MHA, BN, RN,

    Assistant Professor, Corresponding author
    1. Sau Po Centre on Aging, The University of Hong Kong, Hong Kong, China
    • School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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  • Vivian WQ Lou PhD, MSW, MEd,

    Assistant Director, Assistant Professor
    1. Sau Po Centre on Aging, The University of Hong Kong, Hong Kong, China
    2. Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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  • Mike KT Cheung BSc,

    MPhil candidate
    1. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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  • Sophia SC Chan PhD, MPH, MEd,

    Professor and Research Director
    1. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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  • Iris Chi DSW, MSW, BSS

    Professor, The Chinese-American Golden Age Association/Frances Wu Chair for the Chinese Elderly
    1. Sau Po Centre on Aging, The University of Hong Kong, Hong Kong, China
    2. School of Social Work, University of Southern California, Los Angeles, CA, USA
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Correspondence: Angela YM Leung, Assistant Professor, School of Nursing, The University of Hong Kong, Assistant Dean (Student Affairs and Academic Networking), Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4th Floor, William Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong, China. Telephone: +852 2819 2630.

E-mail: angleung@hku.hk

Abstract

Aims and objectives

To develop and to test the psychometric properties of the Chinese Health Literacy Scale for Diabetes.

Background

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.

Design

A methodological study with a sample of 137 patients with type 2 diabetes aged 65 years or older.

Method

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.

Results

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 (= 0·398, < 0·001), the Diabetic Management Self-Efficacy Scale (= 0·257, < 0·001), the Preschool and Primary Chinese Literacy Scale (= 0·822, < 0·001) and the Chinese Value of Learning Scale (= 0·303, < 0·001). It took an average of seven minutes to complete this 34-item instrument.

Conclusion

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.

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