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Construction and validation of the Lebanese Osteoporosis Knowledge Scale among a representative sample of Lebanese women

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Abstract

Summary

Our study aimed at constructing and validating the Lebanese Osteoporosis Knowledge Scale adapted for use among Lebanese women and to assess factors associated with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. This scale showed adequate psychometric properties; higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions.

Introduction

The primary objective of this study was to describe the construction of the Lebanese Osteoporosis Knowledge Scale (LOKS) and assess its psychometric properties in a representative sample of Lebanese women aged 40 years and above. Secondary objectives were to explore factors associated with this knowledge score.

Methods

A cross-sectional study carried out between March and June 2018, enrolled 560 women over the age of 40 years living in the community. This proportionate sample was randomly selected from all Lebanese governorates to cover the entire Lebanese area. A survey was developed and adapted to the Lebanese population based on preexisting scales. Personal interviews were conducted to collect data.

Results

The items of the LOKS were distributed across seven factors with an Eigenvalue over 1 solution, outlining an overall value of 55.89% of the variance. A high Cronbach’s alpha was found for the full scale (0.725). Individuals having a university level of education (beta = 1.62; compared to illiteracy), having heard of osteoporosis (beta = 2.62), taking supplements of calcium and vitamin D compared to none (beta = 0.77), and having had Crohn’s disease (beta = 1.71) had significantly higher knowledge scores of osteoporosis; oppositely, having diabetes (beta = − 1.17), currently taking chemotherapy (beta = − 2.25), and ever having had a fracture (beta = − 0.74) were significantly correlated with lower awareness of osteoporosis.

Conclusions

Our findings suggest that the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. A better knowledge seems to be associated with more preventive measures and less risk of fracture.

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References

  1. Reginster JY, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38(2 Suppl 1):S4–S9

    Article  PubMed  Google Scholar 

  2. Kling JM, Clarke BL, Sandhu NP (2014) Osteoporosis prevention, screening, and treatment: a review. J Women's Health (Larchmt) 23(7):563–572

    Article  Google Scholar 

  3. Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. Osteoporos Int 16(5):447–455

    Article  PubMed  Google Scholar 

  4. Johnell O, Kanis JA, Oden A et al (2004) Mortality after osteoporotic fractures. Osteoporos Int 15(1):38–42

    Article  CAS  PubMed  Google Scholar 

  5. Ballane G, Cauley JA, Luckey MM, El-Hajj FG (2017) Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 28(5):1531–1542

    Article  CAS  Google Scholar 

  6. Baddoura R, Arabi A, Haddad-Zebouni S et al (2007) Vertebral fracture risk and impact of database selection on identifying elderly Lebanese with osteoporosis. Bone 40(4):1066–1072

    Article  PubMed  Google Scholar 

  7. Green LW, Kreuter MW, Deeds SG, Partridge KB, Bartlett E (1980) Health education planning: a diagnostic approach

  8. Lorig K, Konkol L, Gonzalez V (1987) Arthritis patient education: a review of the literature. Patient Educ Couns 10(3):207–252

    Article  CAS  PubMed  Google Scholar 

  9. Ailinger RL, Harper DC, Lasus HA (1998) Bone up on osteoporosis. Development of the Facts on Osteoporosis Quiz. Orthop Nurs 17(5):66–73

    Article  CAS  PubMed  Google Scholar 

  10. Pande KC, de Takats D, Kanis JA, Edwards V, Slade P, McCloskey EV (2000) Development of a questionnaire (OPQ) to assess patient's knowledge about osteoporosis. Maturitas 37(2):75–81

    Article  CAS  PubMed  Google Scholar 

  11. Redman BK (2003) Measurement tools in patient education. Springer Publishing Company

  12. The Central Agency of Statistics in Lebanon website. Available from: www.cas.gov.lb.

  13. El Hage C, Hallit S, Akel M, Dagher E (2019) Osteoporosis awareness and health beliefs among Lebanese women aged 40 years and above. Osteoporos Int 30(4):771–786

    Article  PubMed  Google Scholar 

  14. Antunes B, Daveson B, Ramsenthaler C et al (2012) The palliative care outcome scale (POS) manual for cross-cultural adaptation and psychometric validation. Cicely Saunders Institute, London

    Google Scholar 

  15. Beaton D, Bombardier C, Guillemin F, Ferraz MB (2002) Recommendations for the cross-cultural adaptation of health status measures. New York: American Academy of Orthopaedic Surgeons:1–9

  16. Gemalmaz A, Oge A (2008) Knowledge and awareness about osteoporosis and its related factors among rural Turkish women. Clin Rheumatol 27(6):723–728

    Article  PubMed  Google Scholar 

  17. Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25(24):3186–3191

    Article  CAS  PubMed  Google Scholar 

  18. Al-Bannay H, Jarus T, Jongbloed L, Yazigi M, Dean E (2013) Culture as a variable in health research: perspectives and caveats. Health Promot Int 29(3):549–557

    Article  PubMed  Google Scholar 

  19. Weidmer B. Issues and guidelines for translation in cross-cultural research. Paper presented at: Proceedings of the American Statistical Association, Section on Survey Research Methods1994.

  20. Maneesriwongul W, Dixon JK (2004) Instrument translation process: a methods review. J Adv Nurs 48(2):175–186

    Article  PubMed  Google Scholar 

  21. Nejjari C, El Fakir S, Bendahhou K et al (2014) Translation and validation of European organization for research and treatment of cancer quality of life questionnaire-C30 into Moroccan version for cancer patients in Morocco. BMC research notes 7(1):228

    Article  PubMed  PubMed Central  Google Scholar 

  22. Flesch R (1948) A new readability yardstick. J Appl Psychol 32(3):221

    Article  CAS  PubMed  Google Scholar 

  23. Anastasi A (1954) Psychological testing

  24. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL (2018) Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health;6

  25. Kanis JA, Cooper C, Rizzoli R et al (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30(1):3–44

    Article  CAS  Google Scholar 

  26. Saw S, Hong C, Lee J, et al. Awareness and health beliefs of women towards osteoporosis. Osteoporosis Int 2003;14(7):595–601

    Article  PubMed  Google Scholar 

  27. Magnus JH, Joakimsen RM, Berntsen GK, Tollan A, Søgaard AJ. What do norwegian women and men know about osteoporosis? Osteoporosis Int. 1996;6(1):31–36

    Article  Google Scholar 

  28. Panday K, Gona A, Humphrey MB (2014) Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis 6(5):185–202

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Giangregorio L, Thabane L, Cranney A, Adili A. Osteoporosis knowledge among individuals with recent fragility fracture. Orthopedic nursing. 2010;29(2):99

    Article  CAS  PubMed  Google Scholar 

  30. Marsh HW, Hau K-T, Wen Z (2004) In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Struct Equ Model 11(3):320–341

    Article  Google Scholar 

  31. Oh EG, Yoo JY, Lee JE, Hyun SS, Ko IS, Chu SH (2014) Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial. Res Nurs Health 37(4):292–301

    Article  PubMed  Google Scholar 

  32. Park KS, Yoo JI, Kim HY, Jang S, Park Y, Ha YC (2017) Education and exercise program improves osteoporosis knowledge and changes calcium and vitamin D dietary intake in community dwelling elderly. BMC Public Health 17(1):966

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kanis JA, Cooper C, Rizzoli R et al (2019) Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Calcif Tissue Int 104(3):235–238

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

    S. Hallit, C. El Hage & E. Dagher

  2. INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon

    S. Hallit, P. Salameh, H. Sacre & M. Akel

  3. Notre Dame des Secours Hospital University Hospital Center, Byblos City, Lebanon

    C. El Hage & E. Dagher

  4. Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon

    A. Hajj

  5. Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Saint-Joseph University, Beirut, Lebanon

    A. Hajj

  6. Faculty of Pharmacy, Lebanese University, Beirut, Lebanon

    P. Salameh

  7. Faculty of Medicine, Lebanese University, Beirut, Lebanon

    P. Salameh

  8. Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon

    H. Sacre

  9. Faculty of Science, Lebanese University, Beirut, Lebanon

    C. Rahme

  10. School of Pharmacy, Lebanese International University, Beirut, Lebanon

    M. Akel

Authors
  1. S. Hallit
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  2. C. El Hage
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  3. A. Hajj
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  7. M. Akel
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Corresponding authors

Correspondence to S. Hallit or C. El Hage.

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Ethics statement

In accordance with the Regulatory Research Protocol of the Hospital, the Institutional Review Board of the Holy Spirit University of Kaslik (USEK) approved this study protocol based on the fact that participants’ autonomy and confidentiality have been respected and since it was an observational study, no harm will be caused to them. The purpose and requirement of the study were explained to each woman and they all signed written informed consent.

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Appendix

Appendix

Table 5 Lebanese Osteoporosis Knowledge Scale
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Hallit, S., El Hage, C., Hajj, A. et al. Construction and validation of the Lebanese Osteoporosis Knowledge Scale among a representative sample of Lebanese women. Osteoporos Int 31, 379–389 (2020). https://doi.org/10.1007/s00198-019-05192-3

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  • DOI: https://doi.org/10.1007/s00198-019-05192-3

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