终末期肾病透析患者营养素养量表的编制及测评及其与生活质量的相关性研究。
Development and assessment of a nutrition literacy scale for patients with end-stage kidney disease undergoing dialysis and its correlation with quality of life.
机构信息
School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Department of Nephrology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
出版信息
Ren Fail. 2023 Dec;45(1):2162417. doi: 10.1080/0886022X.2022.2162417.
OBJECTIVES
To construct a valid and reliable Nutritional Literacy Scale for patients with end-stage kidney disease (ESKD) receiving dialysis and evaluate associations between nutrition literacy and quality of life.
METHODS
A total of 208 ESKD patients receiving dialysis were selected for this study. Nutrition literacy evaluation items were drafted based on dietary guidelines for chronic kidney disease (CKD), Literature reviews and expert consultation. Scale reliability and validity were then assessed. Factors influencing nutrition literacy and the associations among nutrition literacy, nutritional status, and quality of life were evaluated.
RESULTS
The scale consists of 28 items with a scale-level content validity index of 0.91 and item-level content validity indices ranging from 0.83 to 1.00. Factor analysis identified 4 common factors (dimensions) named nutrition knowledge, cognitive attitude, behavioral practice, and information acquisition ability that collectively explained 56.31% of literacy score variation. The overall Cronbach's α coefficient of the scale was 0.83, the dimensional Cronbach's α coefficients ranged from 0.79 to 0.87, and the retest reliability was = 0.73 ( < 0.05). Age, education level, residence (urban vs. Rural) , occupational status and dialysis modalities were significant factors influencing nutrition literacy. Nutrition literacy score was negatively correlated with SGA score and positively correlated with serum albumin and prealbumin concen- trations, and with SF-36 quality of life score (all < 0.05).
CONCLUSIONS
This new Nutrition Literacy Scale demonstrates high reliability and validity for Chinese ESKD patients undergoing dialysis. The nutrition literacy is influenced by age, education level, residence, occupational status and dialysis modalities, associated not only with nutritional status but also with quality of life.
目的
构建适用于透析终末期肾病（ESKD）患者的营养素养量表，并评价其与生活质量之间的关系。
方法
共纳入 208 例透析 ESKD 患者，根据慢性肾脏病（CKD）饮食指南、文献回顾和专家咨询，拟定营养素养评估条目，评价量表的信度和效度，分析影响营养素养的因素及营养素养与营养状况、生活质量之间的关系。
结果
该量表共 28 个条目，总量表水平内容效度指数为 0.91，条目水平内容效度指数为 0.831.00。因子分析提取出 4 个公因子（维度），分别命名为营养知识、认知态度、行为实践和信息获取能力，共同解释了总得分 56.31%的变异。总量表 Cronbach's α 系数为 0.83，维度 Cronbach's α 系数为 0.790.87，重测信度为 0.73（ < 0.05）。年龄、文化程度、居住地（城镇 vs. 农村）、职业和透析方式是影响营养素养的显著因素。营养素养得分与 SGA 评分呈负相关，与血清白蛋白和前白蛋白浓度呈正相关，与 SF-36 生活质量评分呈正相关（均 < 0.05）。
结论
该量表具有良好的信度和效度，可用于评估中国透析 ESKD 患者的营养素养。年龄、文化程度、居住地、职业和透析方式影响营养素养，且与营养状况和生活质量相关。
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