- Adequate content validity (CVI=0.85) but low internal consistency: KR-20 0.49 for 21 items, 0.59 after reducing to 10 items.
- Factor analysis suggested unidimensionality, yet item correlations and IRT results showed weak construct coherence and limited information across the trait.
- Test-retest reliability was moderate (ICC=0.67); instrument may be used cautiously as a preliminary screening instrument, but further culturally adapted tools needed.
Arq Neuropsiquiatr. 2026 Nov;84(11):1-10. doi: 10.1055/s-0046-1829130. Epub 2026 Nov 6.
ABSTRACT
BACKGROUND: Population aging in Brazil has increased dementia prevalence and the demand for caregivers. Caregiver knowledge is essential for care quality and clinical outcomes. Robust instruments are needed to assess dementia-related knowledge. The Dementia Knowledge Assessment Tool Version Two (DKAT2) has been transculturally adapted for Brazil.
OBJECTIVE: To evaluate the psychometric properties of the Brazilian version of the DKAT2.
METHODS: A multicenter cross-sectional psychometric study was conducted with caregivers of older adults. Content validity was assessed using the content validity index (CVI). Structural validity was analyzed through exploratory factor analysis after factorability assessment with the Kaiser-Meyer-Olkin index and Bartlett’s test. Internal consistency was estimated using the Kuder-Richardson Formula 20 (KR-20). Item discrimination was examined using point-biserial and tetrachoric correlations. Temporal stability was evaluated with the intraclass correlation coefficient (ICC). Item response theory (IRT) models were used to estimate discrimination, difficulty, and guessing parameters.
RESULTS: A total of 234 caregivers were enrolled, 19 of whom completed a retest assessment. Content validity was adequate (CVI = 0.85). The internal consistency of the original 21-item instrument was low (KR-20 = 0.49). Eleven items showed poor discrimination and were excluded, resulting in a 10-item version with modest improvement (KR-20 = 0.59). Factor analysis suggested unidimensionality, although item correlations were weak. Test-retest reliability was moderate (ICC = 0.67). The IRT analysis indicated limited information across the latent trait continuum.
CONCLUSION: The Brazilian DKAT2 showed adequate content validity and moderate temporal stability, but insufficient internal consistency and limited construct coherence. It may be used cautiously as a preliminary screening instrument, but more robust culturally-appropriate measures are needed.
PMID:42994437 | DOI:10.1055/s-0046-1829130
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