Abstract
Background.
Gestational diabetes mellitus (GDM) is a major public health concern. The International Diabetes Federation estimated that the global prevalence of hyperglycemia in pregnancy is 16.2%. In South Africa, the most recent prevalence of GDM ranges between 9.1-25.8%. Serious adverse events associated with GDM can be mitigated by lifestyle modifications and education. Good comprehension of GDM, and improved understanding has been shown to translate into better glycemic control and reduces peri-natal complications. Assessing the knowledge base of mothers with GDM, whether in a country like South Africa, or any other similar country, is therefore imperative in bridging the gap and improving their understanding and control of their condition.
Objective.
To ascertain the validity and reliability of translated, cross-culturally adapted South African English, Afrikaans and isiXhosa versions of the Malaysian GDM Knowledge Questionnaire (M-GDMKQ).
Methods.
This mixed-method study was conducted prospectively within a high-risk antenatal clinic setting. The study consisted of three phases. Women ≥18-years, with GDM who were able to read basic level English, Afrikaans or isiXhosa; and attended the high-risk antenatal clinic throughout the index pregnancy were consecutively sampled and stratified into three language groups across phases.
Results.
The cross-culturally adapted English, Afrikaans and isiXhosa South African GDMKQ demonstrated reasonable face and content validity. Kappa values ranged between Kappa (SE), -0.03 (0.18) to 0.89 (0.13) for the English version, Kappa (SE), -0.07 (0.18) to 0.53 (0.13) for the Afrikaans version and Kappa (SE), 0.28 (0.18) to 0.87 (0.17) for the isiXhosa version respectively. Cronbach alpha for the individual questions ranged from 0.31 to 0.90, while correlation between overall scores was rho=0.79 (p<0.001).
Conclusion.
While the translated and cross-culturally adaptation South African English, Afrikaans and isiXhosa versions of the GDMKQ were found to be feasible, acceptable and easy to comprehend, more research is required to confirm validity and reliability.