Development, validity and reliability of Tramadol use and misuse knowledge assessment questionnaire

Abstract

The prevalence of tramadol misuse in Nigeria and lack of a quantitative and valid instrument to assess knowledge on the use and misuse of tramadol necessitated this study. The objective of this studywas to develop and validate a questionnaire to assess knowledge about tramadol use and misuse among tramadol users in Benue State of Nigeria. A mixedmethod design was used. Literature review and focus group discussions were conducted to generate items for the questionnaire. Six experts were involved in content validation. The item-level content validity index (I-CVI) cut-off point was set at 0.83. Chain-referral sampling method was applied. Data were collected from tramadol users (n = 200) for the validation study. Item response theory model was applied in the assessment of the psychometric properties of the questionnaire. Cronbach alpha was computed to determine the internal consistency. Ten items were initially deleted for failing to meet the I-CVI cut-off point (I-CVIs < 0.83). The over-all CVI of the questionnaire was 0.86. Five more items were deleted for poor performance in both the difficulty and discrimination parameters, leaving 35 items for the final questionnaire. The reliability coefficient was 0.78 indicating good internal consistency. A valid and reliable self-report questionnaire therefore, emerged for the assessment of knowledge about tramadol in five domains including medical use, prescription, misuse, effects of misuse and withdrawal/detoxification. The questionnaire
can serve as a valid and reliable tool for assessment of knowledge about tramadol and for evaluation of intervention efforts at curtailing tramadol abuse.

Keywords: development; validity; questionnaire; knowledge; tramadol; misuse