| Objective:In this study,the nutritional literacy scale for pd patients was developed and its reliability and validity were tested to provide an effective measurement tool for medical staff to accurately evaluate the nutritional literacy of peritoneal dialysis patients,and to provide guidance for the development of targeted dietary dry preventive measures in the future.Methods:Based on Nutbeam health literacy theory,semi-structured interview method and literature review method were used to construct the scale item pool.The initial scale was formed through two rounds of expert letter consultation.Convenience sampling method was used to investigate 353 patients with peritoneal dialysis in a third class a hospital in Nanchang City,Jingxi Province.Discrete trend method,extreme ratio method and homogeneity test were used to screen items.Cronbach’s α coefficient,retest reliability,content validity,exploratory factor analysis and predictive calibration correlation were used for validity analysis.Results:1.Item pool construction results: Based on literature review,qualitative interview and research group discussion,four themes including belief,functional nutrition literacy,interactive nutrition literacy and critical nutrition literacy were extracted to construct an item pool containing 49 items.2.Initial scale formation results: Effective recoveries of the two rounds of questionnaires were 88.9% and 100.0%,respectively,and expert authority coefficients were 0.938;Kendall’s W of dimension and item were 0.38 and 0.35,respectively,and Kendall’s W of item were 0.27 and 0.13,respectively,with statistically significant differences(P < 0.01).Expert consistency was high.Finally,the initial scale of nutrition literacy in peritoneal dialysis had 4 dimensions and 45 items.3.Item screening results: 10 items were deleted from project analysis and exploratory factor analysis,and 35 items were retained;KMO value of exploratory factor analysis was 0.944,and 7 factors were extracted.Common factors 1,2 and 3were corresponding to three dimensions of critical nutrition literacy,belief and interactive nutrition literacy respectively.According to the theoretical model,common factors 4,5,6 and 7 all belong to the dimension of functional nutrition literacy,which was summarized into the same dimension after discussion by the research group.Finally,a scale with 4 dimensions and 35 items was formed.4.Reliability and validity tests results:(1)Reliability:(1)The overall Cronbach’s α coefficients of the NUTRITIONAL literacy scale of PERitoneal dialysis were 0.947,and the Cronbach’s α coefficients of each dimension were0.788～0.904;(2)The retest reliability coefficient of the total amount table is 0.908,and the retest reliability coefficient of each dimension is 0.741～0.869.(2)Validity:(1)Content validity: S-CVI/Ave was 0.952,i-CVI was 0.889～1.000;(2)Aggregation validity and discriminant validity: The correlation coefficients between items and their dimensions(aggregation validity)were 0.478～0.856,and the correlation coefficients between items and other dimensions(discriminant validity)were 0.207～0.649.The correlation coefficients between each dimension and total score ranged from 0.753 to 0.942.The correlation coefficients of each dimension ranged from 0.460 to 0.703.(3)Exploratory factor analysis: the cumulative contribution rate was 62.823%,and 35 items were single-factor loads with a load range of 0.465～0.795.(4)Prediction calibration: There was a positive correlation between the total score of dietary compliance behavior scale of renal disease and the total score of nutrition literacy scale of peritoneal dialysis patients and the scores of all dimensions(R = 0.351-0.678,P<0.01).Conclusion:The nutrition literacy scale for peritoneal dialysis patients compiled in this study included belief(5 items),functional nutrition literacy(18 items),interactive nutrition literacy(6 items),and critical nutrition literacy(6 items),with a total of 35 items.The scale had good reliability and validity.With the help of this scale,medical staff can evaluate the nutrition literacy level of peritoneal dialysis patients and develop personalized intervention programs for patients with different literacy levels. |
