| Objective:Using the health belief model as a theoretical guide,the Delphi method was used to develop and validate the reliability of a questionnaire on dietary health beliefs of patients with coronary heart disease based on a qualitative study and a review of domestic and international literature.The questionnaire was used to investigate the level of dietary health beliefs of patients with coronary heart disease and their influencing factors,providing a valid reference and a scientific measurement tool for future dietary-related interventions for patients with coronary heart disease.Methods:1.The purpose sampling method was used to select patients with coronary heart disease for qualitative interviews,a semi-structured interview outline was designed based on the health belief model as the theoretical basis,qualitative content analysis was used to analyse the interview data,themes were extracted and combined with the results of domestic and international literature review to construct a pool of entries for the Dietary Health Beliefs Questionnaire.2.Using the convenience sampling method,250 patients with coronary heart disease were selected from a tertiary hospital in Harbin for a pre-survey,and the provisional version of the "Dietary Health Beliefs Questionnaire for Patients with Coronary Heart Disease" was formed after item analysis and exploratory factor analysis to screen the questionnaire entries.A formal survey of 400 patients with coronary heart disease was conducted in a tertiary hospital in Harbin,and the official version of the "Dietary Health Beliefs Questionnaire for Patients with Coronary Heart Disease" was formed after the reliability test.3.Using the convenience sampling method,200 patients with coronary heart disease were selected from a tertiary hospital in Harbin,and the official version of the questionnaire was used to investigate the level of dietary health beliefs of patients with coronary heart disease and to analyze the influencing factors.Results:1.Results of the qualitative study and expert consultation: A total of 12 patients with coronary heart disease were interviewed,and the qualitative content analysis resulted in the distillation of 6 themes and 18 sub-themes,which were used as the basis for forming the initial questionnaire pool of 63 items in combination with the results of the literature review.Fifteen experts from six provinces and one municipality directly under the central government were invited to conduct expert consultations.The average authority coefficient of the experts was 0.82,the questionnaire return rate of the two rounds of expert consultations was 93.8% and 100.0% respectively,and the Kendall coefficients of the two rounds of consultations were 0.283 and 0.350 respectively.2.Questionnaire development: The Coronary Heart Disease Dietary Health Beliefs Questionnaire contains 33 entries in 6 dimensions,the overall content validity index(SICV)of the questionnaire is 0.89,the exploratory factor analysis extracted a total of 6common factors,the cumulative variance contribution of 61.820%,the loading value of each entry is above 0.5 and there is no double loading,the results of the validation factor analysis corrected to 2/df(1.680)< 2,GFI(0.891)close to 0.9,AGFI(0.871)> 0.80,NFI(0.870)close to 0.9,PNFI(0.785)> 0.5,IFI(0.934)> 0.9,TLI(0.936)> 0.9,CFI(0.943)>0.9,RMSEA(0.042)< 0.5,the factor loadings were all above 0.5,the average variance extracted(AVE)was close to or greater than 0.5,the combined reliability(CR)was above0.6,and all indicators were at or close to the standard range.The Cronbach’s alpha coefficient for the questionnaire was 0.913,the folded half reliability was 0.739,and the retest reliability after two weeks was 0.943,which had good reliability and validity.3.Preliminary application of the questionnaire showed that the mean score of dietary health beliefs of coronary heart disease patients was(123.85±15.26),which was at an intermediate level.34.6% of coronary heart disease patients had good dietary health beliefs,58.6% had intermediate dietary health beliefs and 6.8% had poor dietary health beliefs.The results of the independent samples t-test and the one-way ANOVA showed that there were significant differences(p < 0.05)in the dietary health belief scores of coronary heart disease patients by gender,place of residence,education,work status,smoking status,years of illness,and surgical status.Conclusion:This study developed a questionnaire on dietary health beliefs of patients with coronary heart disease,which contains 33 entries in 6 dimensions.The questionnaire is scientifically sound and practical,and can effectively reflect the level of dietary health beliefs of patients with coronary heart disease.The majority of patients with coronary heart disease had moderate beliefs about eating health.General demographic factors such as gender,residence,education,work status,smoking status,years of illness and surgery status were the influencing factors on the beliefs about eating health of patients with coronary heart disease. |
PDF Full Text Request