Table of Contents
Abstract
The South African Gestational Diabetes Mellitus Knowledge Questionnaire (SA-GDMKQ) is a specialized psychometric instrument designed to evaluate the Health Literacy and foundational understanding of Pregnant women diagnosed with gestational diabetes. Adapted from an original Malaysian tool, this measure represents a critical step forward in maternal health psychology by providing a culturally and linguistically tailored assessment for a diverse, lower-resource setting. Gestational diabetes poses significant risks to both maternal and fetal health, including pre-eclampsia, macrosomia, and long-term vulnerabilities to type 2 diabetes. However, these risks can be substantially mitigated when patients actively engage in lifestyle modifications and self-management.
To effectively educate patients, healthcare providers must first accurately gauge their baseline knowledge. The SA-GDMKQ serves this exact function, offering clinicians a standardized method to identify knowledge gaps regarding the condition's risks, dietary requirements, and potential complications. By translating and adapting the tool into English, Afrikaans, and isiXhosa, researchers have ensured that the instrument is accessible to the most prevalent linguistic groups in South Africa's Western Cape region, thereby reducing measurement error associated with language barriers and cultural misunderstandings.
📊 Psychometric Scorecard
15
Multidimensional
0.43
📍 South Africa
Authors
Purpose
The primary purpose of the SA-GDMKQ is to provide a culturally congruent tool for assessing what Pregnant women know about Gestational Diabetes Mellitus. In many primary healthcare settings, particularly in low- and middle-income countries with rural or remote populations, continuous access to medical professionals is limited. Consequently, patient self-management between clinic visits becomes a cornerstone of effective treatment.
Before this adaptation, there was a distinct lack of validated, context-specific instruments available in South Africa to measure this specific domain of Health Literacy. Applying a questionnaire developed for a completely different cultural context often leads to skewed data, as patients might misinterpret culturally specific dietary references or healthcare practices. The SA-GDMKQ fills this critical gap, equipping primary healthcare nurses and educators with a reliable baseline metric to tailor their educational interventions, ultimately empowering patients to achieve better glycemic control.
Construct
The psychological construct measured by the SA-GDMKQ is specific Health Literacy, operationalized as factual knowledge regarding Gestational Diabetes Mellitus. Health Literacy in this context goes beyond mere vocabulary; it encompasses a patient's cognitive grasp of how a physiological condition interacts with daily behaviors and long-term health outcomes.
The construct is multidimensional, capturing five distinct facets of disease comprehension: basic foundational knowledge of the disease, awareness of risk factors, understanding of dietary and food management, knowledge of medical treatment protocols, and recognition of potential maternal and fetal complications. Together, these dimensions form a holistic picture of a patient's readiness to engage in self-care. From a psychometric standpoint, measuring knowledge constructs can be challenging because the items are often formative rather than reflective—meaning the different domains (like diet versus medical treatment) might not highly correlate with one another, even though they all contribute to the overall construct of disease knowledge.
Validity
The validation process for the SA-GDMKQ heavily emphasized establishing robust face and content validity through a rigorous, multi-step Cross-cultural adaptation framework. Rather than simply translating the words, the researchers utilized an expert panel comprising endocrinologists, obstetricians, dieticians, and diabetes educators to ensure semantic and conceptual equivalence. This multidisciplinary approach ensures that the medical facts align with current clinical standards while remaining culturally relevant to the South African context.
Following the expert review, the instrument underwent cognitive pre-testing with subgroups of patients from each of the three target language demographics (English, Afrikaans, and isiXhosa). This qualitative phase confirmed that the target population found the items acceptable, applicable, and easy to comprehend. While the study established a strong foundation for content validity, the researchers noted that further quantitative construct validation in larger samples is necessary to fully establish the scale's psychometric profile.
Reliability
Preliminary reliability testing of the SA-GDMKQ yielded mixed results, highlighting the inherent challenges in measuring broad knowledge constructs with brief instruments. Internal consistency, evaluated via Cronbach's alpha, was relatively low across the three translated versions: 0.434 for English, 0.534 for Afrikaans, and 0.621 for isiXhosa. In psychometric theory, an alpha below 0.70 is generally considered suboptimal. However, for a 15-item knowledge test covering five diverse domains, lower internal consistency is somewhat expected, as knowledge in one area does not necessarily predict knowledge in another.
Test-retest reliability, assessed over a two-week interval to measure temporal stability, also showed significant variability. Cohen's kappa values for individual items ranged widely, from slight negative agreement to strong positive agreement (e.g., -0.03 to 0.89 for the English version). Despite this item-level variance, there was a statistically significant positive linear correlation between the total scores across administrations. These findings suggest that while the overall score demonstrates some stability, the instrument requires further refinement to improve the reliability of individual items.
Factor Analysis
Subscales
| Subscale | Items | Description |
|---|---|---|
| Basic GDM Knowledge | 1-3 | Assesses foundational understanding of what gestational diabetes is. |
| Risk Factors | 4-6 | Evaluates awareness of factors that increase the likelihood of developing the condition. |
| Diet and Food Management | 7-9 | Measures knowledge regarding appropriate nutritional choices and dietary control. |
| Treatment and Management | 10-12 | Assesses understanding of medical interventions and self-monitoring practices. |
| Complications and Outcomes | 13-15 | Evaluates awareness of potential adverse effects on both the mother and the infant. |
Instrument
| Test Type | Self-report questionnaire |
| Format | 15 multiple-choice items, each with three possible answers and one 'I do not know' option |
| Scoring | Items are scored dichotomously: 1 point for a correct answer, and 0 points for an incorrect answer or selecting 'I do not know'. Total scores range from 0 to 15, with higher scores indicating greater knowledge. |
| Language | English, Afrikaans, isiXhosa |
| Population | Pregnant women, Medical patients |
| Age Group | Adults (18 years and older) |
| Administration | Self-administered individually in a clinical setting |
Scoring & Interpretation Guidelines
| Scoring Instructions | 1 point for correct answer, 0 for incorrect or 'I do not know' |
South African Gestational Diabetes Mellitus Knowledge Questionnaire Items
Items are currently not available
The individual items of this scale are not publicly available. Researchers interested in using this instrument should contact the original authors directly to request the scale materials.
Sample
124 Pregnant women (mean age = 32.35 years, SD = 4.96) clinically diagnosed with Gestational Diabetes Mellitus. Participants were consecutively recruited from a high-risk antenatal clinic at a public teaching hospital in the Western Cape province of South Africa, representing lower-income households and rural/remote areas.
Permissions & Test Year
Permission to use and adapt the original English GDMKQ was obtained directly from the original development authors.
Test Year: 2025
Cite This Paper
Lorisha Manas, Tawanda Chivese, Ankia Coetzee, Magda Conradie, Linzette D Morris (2025). South African Gestational Diabetes Mellitus Knowledge Questionnaire. South African family practice : official journal of the South African Academy of Family Practice/Primary Care. https://doi.org/10.4102/safp.v67i1.5826
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Cite this article
Mohammed looti (2026). South African Gestational Diabetes Mellitus Knowledge Questionnaire. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/south-african-gestational-diabetes-mellitus-knowledge-questionnaire/
Mohammed looti. "South African Gestational Diabetes Mellitus Knowledge Questionnaire." PSYCHOLOGICAL SCALES, 14 Aug. 2026, https://scales.arabpsychology.com/s/south-african-gestational-diabetes-mellitus-knowledge-questionnaire/.
Mohammed looti. "South African Gestational Diabetes Mellitus Knowledge Questionnaire." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/south-african-gestational-diabetes-mellitus-knowledge-questionnaire/.
Mohammed looti (2026) 'South African Gestational Diabetes Mellitus Knowledge Questionnaire', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/south-african-gestational-diabetes-mellitus-knowledge-questionnaire/.
[1] Mohammed looti, "South African Gestational Diabetes Mellitus Knowledge Questionnaire," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.
Mohammed looti. South African Gestational Diabetes Mellitus Knowledge Questionnaire. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.