Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2022 Aug;80(8):794-801. doi: 10.1055/s-0042-1755343. Epub 2022 Oct 17.
The ketogenic diet is a therapeutic option to control drug-resistant epileptic seizures and has difficult compliance standards due to adverse effects, psychosocial factors, or dietary restriction.
To create and validate a ketogenic diet compliance questionnaire.
Methodological study, convergent care. The instrument was analyzed (construct validation) by five judges during two cycles of the Delphi technique. The judges assessed the relevance and clarity by using the Likert scale with three levels and made suggestions. The validation of the instrument was calculated using the agreement rate and content validity index (CVI). The application by two nutritionists made it possible to test reproducibility using the Kappa coefficient. When comparing the classification with a template developed by the health professionals who cared for the patients in question, the Pearson correlation and Fisher exact tests were used. For the reliability test, self-applied data were collected and evaluated using Cronbach Alpha coefficient.
The questionnaire initially created with 11 multiple choice questions on a Likert scale was reduced to 10 questions with an agreement rate and the CVI classified as excellent after two rounds with judges. In the application of the tool, a kappa of 0.6087 was obtained, a Pearson that showed no significant difference between evaluators and a Cronbach α of 0.6483, with substantial consistency.
This work resulted in the creation of an unprecedented and reliable questionnaire on adherence to the national ketogenic diet. Further studies should be performed to extrapolate the use of this questionnaire in different populations.
生酮饮食是一种控制耐药性癫痫发作的治疗选择，但由于不良反应、心理社会因素或饮食限制，其依从性标准很难达到。
创建并验证生酮饮食依从性问卷。
方法学研究，汇聚式关怀。该工具通过德尔菲技术两轮周期中的五位评审员进行分析（结构有效性验证）。评审员使用三级李克特量表评估相关性和清晰度，并提出建议。通过一致性比率和内容有效性指数（CVI）计算仪器的验证。由两位营养师应用该工具，使用 Kappa 系数测试了可重复性。在将分类与照顾患者的卫生专业人员开发的模板进行比较时，使用 Pearson 相关系数和 Fisher 确切检验。为了进行可靠性测试，收集并使用 Cronbach Alpha 系数评估自我应用数据。
最初创建的包含 11 个李克特量表多项选择题的问卷在两轮评审后减少到 10 个问题，一致性比率和 CVI 被归类为优秀。在工具的应用中，获得了 0.6087 的 Kappa 值、Pearson 表明评估者之间无显著差异以及 0.6483 的 Cronbach α，具有实质性一致性。
这项工作产生了一个前所未有的、可靠的关于遵守国家生酮饮食的问卷。应进一步开展研究，以推断该问卷在不同人群中的使用。
