Validity and reliability of the Approaches to Dementia Questionnaire (ADQ) in Indonesian health students

Background: Individuals living with dementia often visit healthcare settings, so it is important for health professionals to have appropriate dementia care training. A key component of dementia care is a positive, person-centred attitude towards people with dementia. As future healthcare workers, health students need to develop positive attitudes early in their education. To assess and support the development of such attitudes, a brief, valid, and reliable tool is needed in Indonesia. However, no such tool is currently available in Indonesia. The Approaches to Dementia Questionnaire (ADQ) is a well-established instrument that measures care staff attitudes and has been shown to predict staff behaviour and the recognition of people with dementia. Therefore, this study aims to translate, adapt, and assess the validity and reliability of the Indonesian translation of the modified ADQ for use with health students. Methods: This methodological study was conducted from October to November 2023 to adapt the modified ADQ into Indonesian. The translation process followed established cross-cultural adaptation by Brislin guidelines, including translation, synthesis, expert review, and testing. Two translators from different language institutions translated the instrument into Indonesian (T1 & T2). These two versions were synthesised into an integrated version (T12) by a panel of experts. The final instrument was tested on 161 fourth-year nursing, medical, and health nutrition students recruited through consecutive sampling. Results: The Indonesian version of the ADQ demonstrated an overall internal consistency of 0.584 (Cronbach's alpha), which is considered acceptable. Subscale reliability was moderate for the Hope subscale (α = 0.552) and higher for the Personhood subscale (α = 0.701). Item-total correlation values ranged from 0.261 to 0.588, indicating moderate validity overall; however, three items (Items 1, 6, and 15) were identified as invalid with correlation coefficients below 0.195. Conclusion: The Indonesian version of the ADQ demonstrated lower reliability and variable subscale consistency compared to adaptations in other countries. This may be due to limited public awareness and associated stigma towards dementia. These findings highlight the need for further refinement of item wording and better alignment with local contexts, to improve the tool’s validity and reliability for use in different populations.