Riemann-Lorenz Karin, Seddiq Zai Susan, Daubmann Anne, Pöttgen Jana, Heesen Christoph
Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
Nutrients. 2024 Nov 26;16(23):4043. doi: 10.3390/nu16234043.
BACKGROUND/OBJECTIVES: Persons with MS (pwMSs) are often confronted with contradictory dietary advice, which is not always based on sound scientific evidence. This may lead to poor MS-specific nutrition knowledge (MSNK) and food literacy (MSFL). To date, no studies have assessed MSNK and MSFL among pwMSs. Moreover, no validated tools to measure the effects of educational interventions are available. The aim of this study was to develop and validate MS-specific instruments to measure MSNK and MSFL among pwMSs.
Based on a validated food literacy (FL) screener for the general population and prior research about the information needs of pwMSs, we developed 14 MSFL items and 11 MS-specific nutrition knowledge questions. Cognitive debriefing was conducted with 10 pwMSs and resulted in a 12-item MS food literacy questionnaire (MSFLQ) and an 11-item MS nutrition knowledge questionnaire (MSNKQ). After refinement, both questionnaires were pilot tested in an online survey to explore their comprehensibility. The MSNKQ was analyzed descriptively (mean and percentage of correctly answered questions). For MSFLQ item difficulty, the discriminatory power of the items, internal consistency and convergent/divergent validity were assessed.
In total, 148 pwMSs (age: 47.1 years (SD = 12.5); 102 women (69%)) completed the online survey. On average, participants answered 3.51/11 MSNK questions correctly (31.9%). The MSFLQ showed good internal consistency (Cronbach's alpha = 0.85), item difficulty was good and the discriminatory power of the items was satisfactory. Correlations between the MSFLQ and a general food literacy questionnaire was high (r = 0.626, < 0.001), but only small with the MSNKQ (r = 0.180; = 0.029), underlining the different constructs.
MSNK among pwMSs in Germany is low. The MSNKQ and MSFLQ appear to be suitable instruments to assess MSNK and MSFL and might serve as outcome measures for educational interventions.
背景/目的：多发性硬化症患者（pwMSs）常常面临相互矛盾的饮食建议，而这些建议并非总是基于可靠的科学证据。这可能导致患者对多发性硬化症特定的营养知识（MSNK）和食物素养（MSFL）掌握不足。迄今为止，尚无研究评估pwMSs的MSNK和MSFL。此外，也没有经过验证的工具来衡量教育干预的效果。本研究的目的是开发并验证用于测量pwMSs的MSNK和MSFL的多发性硬化症特定工具。
基于一份经过验证的针对普通人群的食物素养（FL）筛选工具以及先前关于pwMSs信息需求的研究，我们编制了14个MSFL项目和11个多发性硬化症特定的营养知识问题。对10名pwMSs进行了认知访谈，并由此形成了一份包含12个项目的多发性硬化症食物素养问卷（MSFLQ）和一份包含11个项目的多发性硬化症营养知识问卷（MSNKQ）。经过完善后，两份问卷在一项在线调查中进行了预测试，以探究其可理解性。对MSNKQ进行描述性分析（正确回答问题的平均数和百分比）。对于MSFLQ，评估了项目难度、项目的区分度、内部一致性以及收敛/发散效度。
共有148名pwMSs（年龄：47.1岁（标准差 = 12.5）；102名女性（69%））完成了在线调查。参与者平均正确回答了3.51/11个MSNK问题（31.9%）。MSFLQ显示出良好的内部一致性（克朗巴哈系数 = 0.85），项目难度适宜，项目的区分度令人满意。MSFLQ与一份普通食物素养问卷之间的相关性较高（r = 0.626，P < 0.001），但与MSNKQ的相关性较小（r = 0.180；P = 0.029），这凸显了不同的结构。
德国pwMSs的MSNK水平较低。MSNKQ和MSFLQ似乎是评估MSNK和MSFL的合适工具，并且可能用作教育干预的结果指标。
