Devolopment And Application Of The Nutrition Literacy Assessment Questionnaire For Caregivers Of Patients With Stroke In Home

ObjectivesTo devolope the nutrition literacy assessment questionnaire for caregivers of patients with stroke in home,clarify the main content of the questionnaire and test its reliability and validity.Finally,to apply the questionnaire and analyze the nutrition literacy level of caregivers.MethodsThis study was divided into three phases.The first stage:To construct a nutrition literacy assessment questionnaire caregivers of patients with stroke in home.We analyzed and summarized relevant literature,guides,and books,and initially construct the dimensions and items of the questionnaire.A semi-structured interview was conducted with 10 caregivers and 9 community health workers,and the questionnaire dimensions and items were supplemented based on the interview results.Finally,fifteen experts in the field related to this subject were invited to conduct two rounds of Delphi expert consultation on the questionnaire.And a small sample test was conducted to form a questionnaire test draft.The second stage:To test the reliability and validity of the questionnaire.Firstly,we collected 309 questionnaires and used IBM SPSS Statistics 21.0 software to analyze external consistency reliability and exploratory factors of the questionnaire.Secondly,30 questionnaire data were collected for retesting reliability analysis.Finally,we collected 409 questionnaires and use IBM SPSS Amos 21.0 software to perform confirmatory factor analysis and form the final version of the questionnaire.The third stage:To apply preliminarily the nutrition literacy assessment questionnaire for caregivers of patients with stroke in home.IBM SPSS Statistics 21.0 software was used to perform descriptive statistics and one-way analysis of variance on 409 questionnaire data,then to analyze the nutrition literacy level of caregivers.ResultsThe first stage:After a literature review and a semi-structured interview,the questionnaire contained 4 dimensions and 49 items,with cognition and attitude(5 items),functionality(25 items),interactivity(11 items),and criticality(8 items).The second stage:The overall content validity index(S-CVI)of the questionnaire was 0.98,and the content validity index(I-CVI)of each item was 0.830～1.000.The exploratory factor analysis results showed that 4 common factors were extracted,explained a total of 56.492%of the total variation,and the load range was 0.457～0.853.The overall questionnaire Cronbach’s α coefficient was 0.940,and the Cronbach’s αcoefficients of each dimension were 0.877～0.929.The overall half-reliability Guttman Spilt coefficient was 0.767,the retest reliability of the questionnaire was 0.980,and the retest reliability of each dimension was 0.901～0.968.The results of confirmatory factor analysis showed that 23 covariance correlations between different items of the same dimension were added,and χ2/df=1.893、NFI=0.907、IFI=0.954、CFI=0.953、RMSEA=0.047.The questionnaire finally contained 4 dimensions and 36 items,with cognition and attitude(4 items),knowledge mastery(7 items),skills operation(10 items),interaction and assessment of information(15 items).The third stage:The total score of the caregivers was(125.34 ± 25.944).Caregivers had the highest average scores in the cognitive and attitude dimensions,and the lowest average scores in the interaction and assessment of information dimension.The nutrition literacy level of caregivers was low,who were elderly,low education level,poor economic level,spouses of patients,caring for patients with a variety of chronic diseases,and caring for patients who had not received professional nutrition guidance/treatment(P<0.05).ConclusionsThe nutrition literacy assessment questionnaire for caregivers of patients with stroke in home contained 4 dimensions and 36 items,with cognition and attitude(4 items),knowledge mastery(7 items),skills operation(10 items),interaction and assessment of information(15 items).The dimensions and items of the questionnaire could reflect the content requirements of the guiding theory and the nutrition literacy level of caregivers.The reliability,validity,stability,sensitivity,and practicality of the questionnaire were good.The language of the questionnaire was easy to understand,and it could be used as a nutrition literacy assessment tool for caregivers at all cultural levels.The nutrition literacy level of caregivers for stroke in home should be strengthened,especially the capacity of interaction and assessment of nutritional information.In addition,the influential factors of the nutrition literacy level of caregivers contained age,education level,family economic situation,relationship with patients,whether patients had other chronic diseases,and whether patients had received professional nutrition guidance treatment.