Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.

Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.