The Crohn's and Colitis Knowledge Score: A test for measuring patient knowledge in inflammatory bowel disease

OBJECTIVE: The aim of this study waste develop a valid and reliable questio nnaire assessing patient knowledge of inflammatory bowel disease (IBD) and its treatment-the Crohn's and Colitis Knowledge (CCKNOW) Score. METHODS: A total of 30 multiple choice questions were constructed into a dr aft questionnaire. This was piloted on a random selection of participants w ith differing IBD knowledge levels; junior doctors, nurses, and ward clerks . Factor analysis eliminated questions with poor discriminant ability. The resulting 24-item questionnaire (CCKNOW score) was retested on the three gr oups, and a Kruskal-Wallis test determined the questionnaire's ability to d iscriminate between the groups. Reliability and readability were tested usi ng Cronbach's alpha and the Flesch Kincaid reading score. The validated CCK NOW was then rested on patients from the Leicestershire IBD database. RESULTS: CCKNOW scores differed significantly across the groups of doctors, nurses, and ward clerks (median 22, 16, and five, respectively) T = 40.35, p < 0.0001. The reliability was very good with a Cronbach's alpha of 0.95 and the readability was also high. The median score on the CCKNOW for IBD p atients was 10, with no significant difference between ulcerative colitis a nd Crohn's disease. Patients who are members of NACC (National Association of Crohn's and Colitis) achieve statistically significantly higher scores t han do nonmembers (difference in medians 4, 95% confidence interval 4-6, p < 0.0001). CONCLUSIONS: The CCKNOW score provides a valuable index of overall knowledg e. it is self-administered and psychometric tests show it to be valid, reli able, and readable. It may be used in the future as a tool to evaluate pati ent education programs. (Am J Gastroenterol 1999;94:3560-3566. (C) 1999 by Am. Coll. of Gastroenterology).