Cross-cultural Validation of the Mongolian version of the Knowledge about Older Patients Quiz and Kogan’s Attitudes Toward Old People Scale

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Abstract

Background: The aging population is a global phenomenon, particularly in low- and middle-income countries (LMICs), where healthcare systems often struggle to meet the needs of older adults. Ageist attitudes among medical professionals can exacerbate issues related to unmet healthcare needs, resulting in misdiagnosis or improper treatment due to limited clinical guidelines and educational gaps. This study aims to assess the validity and reliability of the Knowledge of Older Patient Quiz (KOP-Q) and Kogan’s Attitude Toward Old People scale in Mongolia. Methods: This study assessed content validity, face validity, construct validity, and internal consistency of the KOP-Q and Kogan’s OP scales. Content Validity Index (CVI) score was given by experts from related fields. A pre-test was conducted among 10 nurses. In the main survey, nurses currently employed in a healthcare setting in Mongolia were recruited to examine construct validity and internal consistency. The following analyses were conducted for construct validity: Item Response Theory (IRT) analyses for the KOP-Q, and Exploratory Factor Analysis (EFA) for Kogan’s OP scale. Internal consistency was examined using Cronbach’s alpha for both scales of interest. Results: Both scales had a high level of content validity, as the CVI was 0.86 for the KOP-Q and 0.91 for Kogan’s OP scale. In the IRT analysis for the KOP-Q, 14 items out of 30 demonstrated moderate to high discrimination parameters, and these difficulty parameters ranged between -0.3 and 2.5. Kogan’s OP scale indicated a single underlying construct, with the first factor having an eigenvalue of 21, and all item loadings exceeding 0.4. The Cronbach’s alpha was 0.80 for the KOP-Q and 0.98 for Kogan’s OP scale. Conclusions: This study successfully developed the Mongolian version of the KOP-Q and Kogan's OP scales for nurses in Mongolia, with content validity, face validity, internal consistency, and partially confirmed construct validity. The results of this study suggested the need for further review and potential revision or removal of the KOP-Q scale.

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