Finally, a feedback from the pilot study, initially done, was taken into consideration to finalize the Arabic version of KAP-45 questionnaire. ![]() Two bilingual Arabic-English speakers translated the original English version of the questionnaire into Arabic, then an expert committee was formed to review and culturally adapt the KAP-45 questionnaire. The KAP-45 questionnaire was validated by a face validity method into Arabic. In the attitude section of the questionnaire, participants were categorized as having a “positive attitude” when they scored three or higher in statements that were indicative of a positive attitude towards diabetes and diabetic retinopathy. In addition, participants were categorized as having “good practice” if they answered four or more of the “must do” questions regarding diabetes and if they answered four or more of the “must do” questions regarding diabetic retinopathy. Participants were categorized as having “sufficient knowledge” if they answered nine or more of the “must know” questions regarding diabetes and if they answered five or more of the “must know” questions regarding diabetic retinopathy. Some of the questions in the knowledge and practice sections of the questionnaire were constructed as open-ended questions, whereas questions in the attitude section were framed as statements. The KAP-45 questionnaire is divided into: 13 questions in the knowledge section (five to assess patients’ knowledge of diabetes and eight to assess patients’ knowledge of diabetic retinopathy), eight questions in the attitude section (four to assess patients’ attitude towards diabetes and four to assess patients’ attitude towards diabetic retinopathy), and 24 questions in the practice section (six to assess patients’ practice patterns regarding diabetes and 18 to assess patients’ practice patterns regarding diabetic retinopathy). 11 Permission to use the KAP-45 questionnaire was granted after communication with its main authors. The Knowledge, Attitude, and Practice −45 points (KAP-45) questionnaire was formulated by Srinivasan et al. The demographic variables included in the study were: gender, age, marital status, educational level, and monthly income. 11 Therefore, the aim of this study was to identify the Knowledge, Attitude, and Practices (KAP) of diabetics towards diabetes and diabetic retinopathy in Riyadh City, Saudi Arabia. In addition, patients with a lack of awareness showed poorer control of DR risk factors. 9 Patients with higher-than-average knowledge of the condition were found to have a positive attitude and a good practice pattern, which gave them the advantage of earlier presentation in their course of illness. 10Īwareness and proper knowledge of this highly prevalent disease is crucial to enhance early detection and proper intervention. 9 Therefore, early detection and treatment are vital to prevent visual loss. 9 Almost all patients are asymptomatic in the early stages of DR, but RCTs found that early screening and intervention could prevent visual loss in patients with DR by 57%. Nevertheless, sudden tight control of blood sugar after a long period of poor control, might initially worsen the retinopathy. Tight control of the blood sugar is highly effective in delaying the onset of and preventing the progression of DR. 7, 8 Studies found that high blood sugar, long duration of DM, and associated high blood pressure are major risk factors for the development of DR. A prevalence of 36% was reported in Al-Medina city, and 33% in Al Ahsa region of Saudi Arabia. 5 Nevertheless, the condition is responsible for 4.8% of blindness worldwide. Studies estimate that 2% of diabetic patients will go blind within 15 years of diagnosis. 4 It is a silent, progressive disease that can lead to irreversible blindness. 3 This number is expected to increase further in the upcoming years.ĭiabetic retinopathy (DR) is one of many devastating ischemic complications of DM. ![]() 2 Alnozha et al reported that DM prevalence in Saudi Arabia was 23.7% in 2011, the second highest among Middle Eastern countries and the seventh highest worldwide according to the WHO ranking. 1 This number is expected to rise to 592 million by 2035. In 2014, the WHO estimated that globally, 422 million people were affected by DM. Diabetes mellitus (DM) is a chronic metabolic disease related to insulin and is one of the most significant worldwide health problems.
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