Zeng Hongji, Zeng Xi, Zeng Nanxi, Zhao Weijia, Zeng Jing, Wang Siyu, Li Yi
School of Public Health, Zhengzhou University, Zhengzhou, China.
Dysphagia Research Institution, Zhengzhou University, Zhengzhou, China.
J Hum Nutr Diet. 2025 Jun;38(3):e70077. doi: 10.1111/jhn.70077.
This study aimed to develop and validate a questionnaire to assess health-related QOL in tube-fed patients, Zeng's Tube-feeding Index (ZTI).
Expert consultations, patient interviews, and literature reviews were used to design the draft items. Four rounds of expert and patient review were conducted to refine the items. A preliminary survey was conducted for the dimension division. In 2024, a formal study involving 419 tube-fed patients was conducted to validate the ZTI. The primary diagnoses were haemorrhagic stroke (83, 19.81%), ischaemic stroke (156, 37.23%), traumatic brain injury (70, 16.71%), neurodegenerative diseases (58, 13.84%), head and neck cancer (11, 2.26%), sarcopenia (16, 3.81%), and others (25, 5.97%), respectively. The Cronbach's α coefficient was used to measure internal consistency. Spearman's correlation was used to measure test-retest reliability. The Dysphagia Handicap Index and subjective QOL scores were used to measure the construct validity. Ten independent experts were included to evaluate content validity. Factor analyses were used for structural validity.
The ZTI has four dimensions, with a total of 23 items, using a Likert 4-point scale. The Cronbach's α coefficients were > 0.8 for dimensions and = 0.889 for the scale. The Spearman correlation coefficients were > 0.7 for items or dimensions, and = 0.802 for the scale (p < 0.001). The ZTI showed significant correlations with the Dysphagia Handicap Index and subjective QOL scores in both the total scores and each dimension (|r| > 0.7, p < 0.001). The content validity indices were ≥ 0.8 for items, dimensions, and the scale. The Exploratory Factor Analysis identified four factors that collectively explained > 80% of the variance and built a four-dimensional model. The model showed a good fit through the Confirmatory Factor Analysis.
The ZTI is a validated tool for assessing tube-feeding-related QOL.
本研究旨在开发并验证一份用于评估管饲患者健康相关生活质量的问卷——曾氏管饲指数（ZTI）。
采用专家咨询、患者访谈和文献回顾来设计初始条目。进行四轮专家和患者评审以完善条目。进行初步调查以划分维度。2024年，开展一项涉及419名管饲患者的正式研究以验证ZTI。主要诊断分别为出血性卒中（83例，19.81%）、缺血性卒中（156例，37.23%）、创伤性脑损伤（70例，16.71%）、神经退行性疾病（58例，13.84%）、头颈癌（11例，2.26%）、肌肉减少症（16例，3.81%）以及其他（25例，5.97%）。采用Cronbach's α系数来衡量内部一致性。采用Spearman相关性来衡量重测信度。采用吞咽障碍 handicap指数和主观生活质量评分来衡量结构效度。纳入10名独立专家评估内容效度。采用因子分析来评估结构效度。
ZTI有四个维度，共23个条目，采用Likert 4级量表。各维度的Cronbach's α系数>0.8，量表的Cronbach's α系数为0.889。各条目或维度的Spearman相关系数>0.7，量表的Spearman相关系数为0.802（p<0.001）。ZTI在总分及各维度上与吞咽障碍 handicap指数和主观生活质量评分均呈显著相关（|r|>0.7，p<0.001）。各条目、维度及量表的内容效度指数≥0.8。探索性因子分析确定了四个因子，它们共同解释了>80%的方差，并构建了一个四维模型。通过验证性因子分析，该模型显示拟合良好。
ZTI是一种经过验证的用于评估管饲相关生活质量的工具。
