| Objective : Based on the theory of knowledge,belief and behavior,to compile a nutritional knowledge,belief and behavior questionnaire for maintenance hemodialysis patients to test its reliability and validity,and to provide clinical medical workers with an evaluation tool;preliminary application of the questionnaire to investigate the nutritional knowledge,attitude and behavior status of maintenance hemodialysis patients.Compare the differences between groups of different demographic characteristics and make reasonable suggestions.Methods:This study formed a questionnaire item pool through qualitative interviews,literature analysis,and expert focus interviews,and then formed the initial version of the questionnaire through Delphi expert correspondence,and conducted item screening and reliability and validity tests on the questionnaire.1.Qualitative interviews: Semi-structured interviews were used to conduct in-depth interviews with 11 maintenance hemodialysis patients,and the content was analyzed using Colaizzi data analysis methods.2.Delphi expert letter inquiry: a questionnaire item pool is formed on the basis of preliminary literature study,qualitative interviews,and expert focus group interviews.After collation,an expert letter questionnaire is formed.After two rounds of letter inquiry for 14 experts,the initial questionnaire is formed Version of the questionnaire on nutritional knowledge,attitude and practice of maintenance hemodialysis patients.3.Questionnaire reliability and validity test: The initial version of the questionnaire is distributed to the clinic,and the four methods of entry threshold,correlation coefficient,Cronbach ? ? coefficient method and factoranalysis method are used to screen and the questionnaire items are screened according to the actual professional situation.Form the final version of the questionnaire and make a reliability and validity evaluation.4.Cross-sectional survey: The final version of the questionnaire was distributed at six hemodialysis centers in Lu'an City,and the basic demographic data of the patient,the physical and biochemical indicators of nutrition students,and the health-related quality of life scale(SF12)were added.Perform statistical analysis.Results: 1.Three themes were extracted through interviews(learning experience of diet-related knowledge,experience of dietary belief and attitude formation,and experience of related behavior management).2.Expert authority level is 0.889 in the first round,0.882 in the second round,the average coefficient of variation of items in the first round is 0.187,and the second round is 0.099,the Kendall coordination coefficient is 0.157 in the first round,and 0.156 in the second round.Significant.3.In the reliability and validity of the questionnaire,the overall Cronbach?? coefficient of this questionnaire is 0.853,the split-half reliability is 0.777,and the test-retest reliability is 0.880;the content validity I-CVI fluctuates between 0.91-1.0,and the exploratory factor analysis extracts 9 common factors,a cumulative contribution rate of62.912%,confirmatory factor analysis model indicators ?(17)/df,RMSEA,IFI,TLI,CFI are all ideal,the load of each factor in the convergent validity is greater than 0.3,the combined reliability is greater than 0.7,distinguish The validity correlation coefficient is positive and less than 0.5,less than the square root of AVE,and the discrimination validity is ideal.4.Cross-sectional survey The total score of the questionnaire on nutritional knowledge and information for maintenance hemodialysis patients is(75.00±19.90)points,and the total score of thequestionnaire is 145 points.The knowledge dimension score is(19.28±11.57)points,the attitude dimension score is(29.3±4.07)points,and the behavior dimension score is(26.42±6.27)points.The nutritional indicators of hemoglobin,albumin,and transferrin were positively correlated with each dimension and the total questionnaire,and they were statistically significant(P(27)0.05).In univariate analysis,age,dialysis age,marriage,gender,family monthly income,education level,medical insurance payment method,primary disease,and occupation all have an impact on the questionnaire score(P(27)0.05).After entering the multiple linear regression analysis,culture is found Compared with illiteracy(reference),the level category of elementary and middle school,junior high school,high school,junior high school,junior high school and above has a statistically significant and positive correlation(?=0.178,0.543,0.399,0.261,P(27)0.001,P=0.006)),in the occupation category,workers,other occupations and farm names(reference)have a statistically significant and positive correlation with the total score of the questionnaire(?=0.131,0.150,P=0.005,0.028),gender has a positive effect on the total score of the questionnaire The impact is statistically significant and positively correlated(?=0.102,P=0.045),dialysis age has a statistically significant and positive correlation with the questionnaire total score(? =0.153,P=0.004),age has an impact on the questionnaire total score It is also statistically significant and negatively correlated(?=0.174,P=0.007).After controlling for gender,age and other influencing factors,the partial correlation analysis between SF12 and the nutritional knowledge,information and behavior questionnaire scores of maintenance hemodialysis patients was carried out.The results showed that the nutritional knowledge,information and behavior questionnaire scores of maintenance hemodialysis patients were positively correlated with the SF-12 scores.Statistical significance(P(27)0.05).conclusion:1.The nutritional knowledge,belief and behavior questionnaire for maintenance hemodialysis patients has ideal reliability and validity and is suitable for clinical work.2.The overall scores of the surveyed maintenance hemodialysis patients' nutritional knowledge,attitudes and behaviors questionnaire are average.Among them,the attitude dimension is acceptable,and the knowledge dimension and behavior dimension are low.Therefore,the focus of clinical care of maintenance hemodialysis patients should be to strengthen diet and nutrition-related knowledge and behavior Intervention.3.The patient's age,dialysis age,marriage,gender,family monthly income per capita,education level,medical insurance payment method,primary disease,occupation are the factors that affect the questionnaire score,among which education level,occupation,gender,dialysis age,and age are The main influencing factors. |
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