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Evaluating the European Health Literacy Survey Questionnaire in Patients with Stroke: A Latent Trait Analysis Using Rasch Modeling
- Source :
- The Patient - Patient-Centered Outcomes Research. 11:83-96
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- The effective self-management and treatment of long-term disability after stroke depends greatly on the health literacy of patients. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a comprehensive and theory-based measure that captures multiple self-perceived competencies of health literacy and covers a diverse range of health contexts. However, there is no psychometric evidence on the HLS-EU-Q in the stroke population. The aim of this study was to examine the validity of the HLS-EU-Q in patients with stroke using Rasch analysis. We compared the model deviance among the one-domain, three-domain, four-domain, and 12-domain structures using likelihood ratio tests to determine the dimensionality of the HLS-EU-Q. Thereafter, we examined the unidimensionality of each domain, local independence, item fit, response categories, and differential item functioning (DIF) for the best fitting structure. A total of 311 patients with stroke participated in this study. Rasch analysis revealed that the 12-domain HLS-EU-Q demonstrated the best data–model fit. The original 4-point scales showed disordering, which can be corrected by rescaling them as 3-point scales with the two middle categories collapsed. All 47 items in the rescaled HLS-EU-Q fit the 12-domain Rasch model, demonstrated local independence, assessed the 12 unidimensional domains respectively, and had invariant difficulties between different age or education groups of the patients with stroke. We recommend using the 12-domain scores of the rescaled HLS-EU-Q to comprehensively and accurately capture the competencies to access, understand, appraise, and apply health information within the three health contexts of healthcare, disease prevention, and health promotion for patients with stroke.
- Subjects :
- Male
Health Knowledge, Attitudes, Practice
medicine.medical_specialty
Psychometrics
Population
Health literacy
03 medical and health sciences
0302 clinical medicine
Patient Education as Topic
Surveys and Questionnaires
Health care
medicine
Humans
Prospective Studies
030212 general & internal medicine
Hospitals, Teaching
Psychiatry
education
Aged
education.field_of_study
Rasch model
business.industry
Communication
Self-Management
030503 health policy & services
Public health
Reproducibility of Results
Middle Aged
Differential item functioning
Health Literacy
Stroke
Health promotion
Chronic Disease
Female
0305 other medical science
business
Clinical psychology
Subjects
Details
- ISSN :
- 11781661 and 11781653
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- The Patient - Patient-Centered Outcomes Research
- Accession number :
- edsair.doi.dedup.....ce82f1d8557c18e8829a06b581906d01