Abstract
Background
The co-circulation of arboviruses like dengue, Zika, and chikungunya presents a remarkable diagnostic and management challenge in the Americas, particularly in countries with compromised health systems like Venezuela. Physicians are central to an effective response, yet no validated instrument exists to assess their preparedness. This study aimed to develop and psychometrically assess the first comprehensive survey to identify knowledge gaps and factors influencing the clinical management of arboviruses among Venezuelan physicians.Methods
A cross-sectional validation study was conducted from April to May 2025 using a 47-item online survey administered to physicians in Venezuela. Psychometric properties were evaluated through item analysis, exploratory factor analysis (EFA) with Promax rotation, and two-step cluster analysis to establish performance categories. Internal consistency was assessed using Cronbach's alpha and the Kuder-Richardson 20 (KR-20) coefficient.Results
The instrument demonstrated preliminary evidence supporting construct validity. EFA of the attitudes and practices scales revealed two-factor structures, distinguishing between "Proactive Stance" and "Risk Perception" (attitudes), and between "Patient-Centered Education" and "Systemic Public Health Engagement" (practices). Internal consistency coefficients for the multi-dimensional knowledge (KR-20 = 0.52) and attitudes (Cronbach's alpha = 0.523) scales reflected these construct's heterogenicity, while the practices scale showed acceptable consistency (Cronbach's alpha = 0.691). Illustrative application of the instrument revealed that 43.8% of physicians had low knowledge, mainly among non-frontline physicians (55% vs. 37.3%, p = 0.028). A significant attitude-practice gap was identified, driven by low performance on system-dependent behaviors like disease notification.Conclusions
This study presents a newly developed instrument with preliminary psychometric support for assessing physician preparedness for arboviral diseases in endemic, resource-limited settings. The tool aims to differentiate between individual clinical competencies and system-dependent practices, offering a structured approach to designing targeted medical education strategies and strengthening public health infrastructure in similar contexts. Further studies with larger samples are warranted to improve its psychometric properties and identify KAP gaps among physicians.