Table 2.
Knowledge domain
| No | Domain and item generation | Phase I | Phase II | Phase III | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| I-CVI | Conclusion | Item difficulty | Discriminating index | Quality of response alternatives | Conclusion | Factor loading | “fit indices” of CFA | Cronbach’s Alpha | ||
| Topic: Definition and characteristic of older adult |
Multifocal model with three factors CFI = 0.87 TLI = 0.82 RMSEA = 0.04 |
Overall: 0.83 F1: 0.77 F2: 0.78 F 3: 0.74 |
||||||||
| 1 |
Older adults in Indonesia is defined as: a. People aged ≥ 50 years b. People aged ≥ 60 years* c. People aged ≥ 70 years |
1 | Retained | 0.40 |
0.09c Cronbach’s Alpha if item deleted = 0.85 |
Options: a = 0.25 c = 0.35 |
Deleted | Item deleted/ not tested | ||
| 2 |
What is characteristic of older adults: a. Have limited regenerative abilities* b. Have limited activity daily living c. Have limited interaction with people |
< 1 | Deleted | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | ||
| 3 |
The normal changes that occur in the older adult’s skin are: a. The skin becomes wrinkled and moist b. The skin becomes wrinkled and gets wet easily c. The skin becomes wrinkled and dries easily* |
1 | Retained | 0.72 |
0.63 Cronbach’s Alpha if item deleted = 0.81 |
Options: a = 0.19 b = 0.17 |
Retained | 0.58 (factor 3) | ||
| Topic: Definition of PI and symptoms associated with PIs | ||||||||||
| 4 |
A Pressure injury is: a. An injury that occurs due to the use of diapers b. An injury on the skin which usually occurs over a bony prominence as a result of pressure* c. An injury that occurs due to pressed by tight clothes |
1 | Retained | 0.30 |
0.50 Cronbach’s Alpha if item deleted = 0.82 |
Options: a = 0.50 c = 0.20 |
Retained | 0.47 (factor 3) | ||
| 5 |
A pressure injury can also be defined as: a. An injury on the skin over a bony prominence as a result of shear b. An injury on the skin because of heat c. An injury on the skin because of diabetic |
< 1 | Deleted | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | ||
| 6 |
Symptom(s) of pressure injuries are: a. The skin looks reddish b. There is visible skin damage/wounds c. Options A and B are correct* |
1 | Retained | 0.72 |
0.68 Cronbach’s Alpha if item deleted = 0.80 |
Options: a = 0.18 b = 0.10 |
Retained | 0.42 (factor 3) | ||
| Topic: Cause and consequences of PIs | ||||||||||
| 7 |
The cause of a pressure injury is: a. Continuous pressure and shear against the skin* b. Squeezed objects falling on the body c. The pressure of clothes attached to the body |
1 | Retained | 0.53 |
0.54 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.13 c = 0.34 |
0.67 (factor 2) | |||
| 8 |
Pressure injuries in older adults can cause: a. Pain and infection* b. Nausea and vomiting c. Urinary incontinence |
1 | Retained | 0.67 |
0.62 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.14 c = 0.19 |
Retained | 0.48 (factor 2) | ||
| 9 |
Pressure injuries in older adults can make them: a. Difficult to mobile* b. Difficult to urinate c. Difficult to concentrate |
< 1 | Deleted | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | ||
| 10 |
What will happen if redness in the skin of older adults is left untreated? a. It will develop into deep pressure ulcers* b. It becomes blackish and then heals c. It will heal itself when the skin is dry |
1 | Retained | 0.08b |
0.36c Cronbach’s Alpha if item deleted = 0.83 |
Options: b = 0.32 c = 0.60 |
Deleted | Item deleted/ not tested | ||
| Topic: Preventive strategies that family caregivers can perform to prevent PIs | ||||||||||
| 11 |
What to do to prevent pressure injuries in older adults? a. Wear loose clothes b. Use footwear when leaving the house c. Prevent prolonged pressure on the skin* |
1 | Retained | 0.38 |
0.49 Cronbach’s Alpha if item deleted = 0.82 |
Options: a = 0.42 b = 0.20 |
Retained | 0.44 (factor 1) | ||
| 12 |
What to do to prevent redness on older adult’s skin? a. Prevent shear on the skin b. Prevent applying lotion on the skin c. Prevent using hard mattress |
< 1 | Deleted | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | ||
| 13 |
Pressure ulcers in older adults can also be prevented by: a. Adequate feeding and drinking* b. Sunbathing c. Prevent stress on older adults |
1 | Retained | 0.66 |
0.62 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.13 c = 0.21 |
Retained | 0.92 (factor 1) | ||
| 14 |
For immobile/ bedridden older adults, what should be done to prevent pressure injuries? a. Mobilization to the left and right sleeping position* b. Positioning the older adults always sleeps on their back without any wedge c. Let older adults sleep without being disturbed |
1 | Retained | 0.49 |
0.58 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.31 c = 0.20 |
Retained | 0.95 (factor 1) | ||
| 15 |
A thing that should be done on older persons' dry skin to avoid pressure injuries is: a. Apply powder to keep the skin dry b. Moisturizes dry skin* c. Cover the dry skin with a bandage |
1 | Retained | 0.53 |
0.60 Cronbach’s Alpha if item deleted = 0.81 |
Options: a = 0.23 c = 0.24 |
Retained | 0.44 (factor 1) | ||
| 16 |
A thing that should be done when an older persons' skin turns red is: a. Let it dry itself b. Release pressure and shear* c. Give betadine or iodine |
1 | Retained | 0.75 |
0.70 Cronbach’s Alpha if item deleted = 0.81 |
Options: a = 0.15 c = 0.10 |
Retained | 0.45 (factor 1) | ||
| 17 |
A thing that should be done if the skin of an older adult shows deep pressure injury is: a. Take the older adults to health care services* b. Treat using honey c. Let it open |
1 | Retained | 0.71 |
0.59 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.17 c = 0.12 |
Retained | 0.95 (factor 1) | ||
| 18 |
What to do to prevent deep pressure injuries in older adults: a. Consult the injuries to health care provider* b. Apply a traditional medicine like honey or coffee c. I do not know the answer |
< 1 | Deleted | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | Item deleted/ not tested | ||
| 19 |
Using a special mattress for older adults can prevent pressure injuries. This statement is: a. True* b. False c. I do not know |
1 | Added | 0.49 |
0.58 Cronbach’s Alpha if item deleted = 0.81 |
Options: b = 0.36 c = 0.15 |
Retained | 0.92 (factor 1) | ||
Note:
*correct answers
aValue of person correlation (r-value) smaller than r-table
bValue of item difficulty smaller than 0.10 or larger than 0.90
cValue of discriminant index (D value) smaller than 0.40