Patient knowledge of rotator cuff related shoulder pain condition and treatment and validation of a patient-reported knowledge questionnaire

      Introduction: Rotator Cuff Related Shoulder Pain (RCRSP) knowledge is an important contributor to patient adherence and providing high-quality guideline-recommended care. There are no validated instruments for measuring health literacy levels among people with RCRSP. This study aimed to design a valid and reliable instrument to measure RCRSP health literacy that could be used to evaluate health literacy in research and clinical settings.
      Methods: 38 RCRSP patients and 33 patients with other types of shoulder pain, who were predominantly females in their early 50’s, having pain for 30+ weeks were recruited through social media. The patient knowledge questionnaire (PKQ-RCRSP) development occurred in three phases. Phase 1 was developed based on available literature and input from expert clinicians, researchers, and patients. Face validity, pilot testing and readability assessment were also undertaken. In phase 2, internal consistency and predictive validity were assessed in people with RCRSP and other shoulder pain diagnoses. Phase 3 included RCRSP health literacy assessment.
      Results: Face validity was acceptable and pilot testing identified minor accuracy issues that were corrected. Literacy level was rated as ‘difficult to read’ which reflects the medical terminology within the questionnaire. Internal consistency was very good and 81% of questions demonstrated acceptable predictive validity. Health literacy was heterogeneous depending on the question with less than 40% of respondents answering correctly for questions related to the indications, process, and the known benefits of RCRSP surgery.
      Discussion: The PKQ‐RCRSP demonstrated acceptable face validity, predictive validity and reliability (internal consistency) in assessing RCRSP health literacy. Health literacy among our small sample was poor for questions related to surgery for RCRSP. Our findings suggest that these aspects of RCRSP knowledge are not intuitive and may require specific education so that people avoid potentially unnecessary surgery.
      Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.