Development and Preliminary Application of a KAP Scale for Nursing Assistants in Pain Care for Older Adults With Dementia

ABSTRACT Aim This study aimed to develop and preliminarily validate the KAP scale for pain management in older adults with dementia among nursing assistants. Design A cross‐sectional study. Methods An initial item pool was constructed through literature reviews, semi‐structured interviews and team discussions. Items were screened and optimised through two rounds of Delphi expert consultations, a pilot survey and item analysis, yielding a draft version of the scale. Psychometric evaluation was conducted to refine the scale into its final form. Results The final KAP scale developed in this study comprised 31 items. The scale exhibited good content validity, with item‐level content validity index (I‐CVI) values ranging from 0.83 to 1.00. Exploratory factor analysis revealed that the scale extracted five factors, which accounted for 65.732% of the cumulative variance, and all items demonstrated rotated factor loadings > 0.5, indicating good construct validity. The Cronbach's α coefficients for the knowledge, attitudes and practices dimensions were 0.877, 0.915 and 0.935, respectively, and the split‐half reliability coefficients were 0.909, 0.886 and 0.864. Conclusion The KAP scale for pain care in older adults with dementia developed in this study possesses good reliability and validity and can be used to assess the knowledge, attitudes and behavioural levels of nursing assistants in pain care. Implications for the Profession and/or Patient Care This study developed and psychometrically validated a KAP scale specifically designed to assess pain care for older adults with dementia among nursing assistants. Clinical managers can utilise this tool to systematically identify deficiencies in staff members' knowledge, attitudes or practices, thereby providing scientific evidence for the development of targeted pain care training programs and pain management strategies. This contributes to enhancing nursing assistants' pain care competence, ultimately alleviating the pain burden of older adults with dementia and improving their quality of life. Reporting Method The STROBE checklist was used as a guideline. Patient or Public Contribution No patient or public involvement.