Purpose: Chronic kidney disease (CKD) is a global public health priority. Adherence to complex therapeutic regimens is crucial for non-dialysis patients. However, the absence of multidimensional assessment instruments has impeded precise adherence evaluation and targeted interventions. This study aimed to develop and validate a disease-specific Treatment Adherence Scale for Non-Dialysis CKD Patients (TAS-NCKD). Methods: A cross-sectional mixed-methods study was conducted in China. Preliminary items were developed by a scoping review and two Delphi expert rounds. Three rounds of surveys (n=160, 350, and 370) were conducted for the construction and psychometric validation of the scale. Feasibility, reliability, validity, discrimination and difficulty, and optimal cutoff determination was verified. Results: The third validation cohort consisted of 181 patients with CKD stage 1, 49 with stage 2, 59 with stage 3, 38 with stage 4, and 43 with stage 5. The final TAS-NCKD comprises 45 items across 5 dimensions. The scale demonstrated high feasibility with a completion rate of 92.5%, and a completion time within 18 minutes. The Cronbach’s α, split-half reliability, test-retest reliability for the scale were 0.955, 0.968, and 0.836. The scale-level content validity index (CVI) and item-level CVI were 0.992 and 0.875– 1. Confirmatory factor analysis showed a good model fit. Convergent and discriminant validity both met the standards. Item characteristic curves were ideal and the optimal cutoff was established at 179 points. Conclusion: The TAS-NCKD is a valid and reliable instrument for assessing treatment adherence in Chinese non-dialysis CKD patients. This study provides targeted insights for improving patient self-management and may help slow disease progression. Keywords: chronic kidney disease, non-dialysis, treatment adherence, scale development and validation, China
Cui et al. (Sun,) studied this question.