What question did this study set out to answer?

The study aims to develop and validate a questionnaire to assess knowledge, attitudes, and practices in pediatric pain management for healthcare professionals.

June 14, 2026BMC Health Services Research0 citationsOpen Access

Development and validation of the knowledge, attitudes, and practices (KAP) questionnaire on pediatric pain management for physicians and nurses

QSQiao ShenChildren's Hospital of Chongqing Medical University XWXiaoqiong WeiChildren's Hospital of Chongqing Medical University LWLiu WKunming University of Science and Technology

Key Points

The study aims to develop and validate a questionnaire to assess knowledge, attitudes, and practices in pediatric pain management for healthcare professionals.
Developed a preliminary item pool from the literature and refined it through Delphi consultations with experts.
Conducted a pilot test with 20 healthcare professionals for clarity.
Administered the questionnaire to 603 healthcare providers at a children's hospital for psychometric validation.
The final questionnaire consists of 32 items demonstrating high content validity indices (I-CVI: 0.86–1.00).
Cronbach’s α was 0.96, with individual dimensions ranging from 0.92 to 0.98, indicating excellent reliability.
Exploratory factor analysis revealed three factors, explaining over 70% of the variance, and supported by confirmatory factor analysis.

Abstract

Effective pediatric pain management is often hindered by gaps in medical staff’s knowledge, attitudes, and practices. Few reliable instruments comprehensively measure these domains. This study aimed to develop and preliminarily validate a Knowledge, Attitudes, and Practices (KAP) Questionnaire on pediatric pain management for physicians and nurses. A preliminary pool of items was generated from a literature review and refined through two rounds of Delphi consultations with 19 multidisciplinary experts. A pilot test with 20 physicians and nurses was conducted to ensure clarity. In June 2024, a convenience sample of 603 physicians and nurses from a specialized children’s hospital in Chongqing, China, completed the questionnaire for psychometric validation. The final questionnaire comprised 32 items across three dimensions (knowledge: 13; attitudes: 10; practices: 9), a self-report tool using a five-point Likert scale. Items showed good discrimination (CR: 12.29–19.78) and acceptable item–total correlations ( r = 0.49–0.72). Content validity indices were high (I-CVI: 0.86–1.00; S-CVI/Ave: 0.996). The overall Cronbach’s α was 0.96, with values for the three dimensions ranging from 0.92 to 0.98. Exploratory factor analysis extracted three factors explaining 70.56% of the variance (KMO = 0.95; Bartlett’s χ ² = 12,459.51, p < 0.001), supporting construct validity, and confirmatory factor analysis supported the three-factor structure (CFI = 0.90, TLI = 0.90, RMSEA = 0.10, SRMR = 0.06). Convergent validity was supported by average variance extracted values ranging from 0.56 to 0.84. Discriminant validity was established as the square root of the AVE for each factor (knowledge: 0.79; attitudes: 0.92; practices: 0.75) exceeded its inter-factor correlations. The pediatric pain management KAP questionnaire demonstrated adequate psychometric properties in this initial validation. It provides a practical tool to assess physicians’ and nurses’ knowledge, attitudes, and practices, supporting the identification of gaps and guiding targeted training and quality improvement initiatives to enhance pediatric pain care.

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